Provider Demographics
NPI:1801200100
Name:MERCURY LABORATORY SERVICES, LLC
Entity Type:Organization
Organization Name:MERCURY LABORATORY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:TRONOWN
Authorized Official - Middle Name:V
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:832-928-9316
Mailing Address - Street 1:21602 E. HARDY RD.
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77073
Mailing Address - Country:US
Mailing Address - Phone:281-602-3491
Mailing Address - Fax:281-602-3496
Practice Address - Street 1:28533 SPRING TRAILS RIDGE STE. #200
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386
Practice Address - Country:US
Practice Address - Phone:281-602-3491
Practice Address - Fax:281-602-3496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-13
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory