Provider Demographics
NPI:1679508204
Name:CYTO SPECIALTY LAB, INC.
Entity Type:Organization
Organization Name:CYTO SPECIALTY LAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:M
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-659-7800
Mailing Address - Street 1:8626 TESORO DR STE 700
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-6234
Mailing Address - Country:US
Mailing Address - Phone:210-653-7800
Mailing Address - Fax:210-590-8986
Practice Address - Street 1:8626 TESORO DR STE 700
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-6234
Practice Address - Country:US
Practice Address - Phone:210-653-7800
Practice Address - Fax:210-590-8986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCL0066Medicare ID - Type Unspecified