Provider Demographics
NPI:1710193677
Name:IRIZ PEREZ
Entity Type:Organization
Organization Name:IRIZ PEREZ
Other - Org Name:HOPE MEDICAL LAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IRIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-307-6654
Mailing Address - Street 1:96 HAYES ST STE 102
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-8007
Mailing Address - Country:US
Mailing Address - Phone:877-307-6654
Mailing Address - Fax:
Practice Address - Street 1:96 HAYES ST STE 102
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-8007
Practice Address - Country:US
Practice Address - Phone:877-307-6654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory