Provider Demographics
NPI:1891547477
Name:ON SITE SAMPLES LLC
Entity Type:Organization
Organization Name:ON SITE SAMPLES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARRONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-462-1292
Mailing Address - Street 1:801 TRAVIS ST STE 2101
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-5730
Mailing Address - Country:US
Mailing Address - Phone:601-462-1292
Mailing Address - Fax:
Practice Address - Street 1:801 TRAVIS ST STE 2101
Practice Address - Street 2:STE 2101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-5730
Practice Address - Country:US
Practice Address - Phone:601-462-1292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder