Provider Demographics
NPI:1588006589
Name:CMG LABORATORIES, LLC
Entity Type:Organization
Organization Name:CMG LABORATORIES, LLC
Other - Org Name:GENERATION DIAGNOSTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-790-1990
Mailing Address - Street 1:7400 FANNIN ST
Mailing Address - Street 2:SUITE 700C
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1920
Mailing Address - Country:US
Mailing Address - Phone:713-790-1990
Mailing Address - Fax:713-790-1903
Practice Address - Street 1:7400 FANNIN ST
Practice Address - Street 2:SUITE 700C
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1920
Practice Address - Country:US
Practice Address - Phone:713-790-1990
Practice Address - Fax:713-790-1903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1699291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory