Provider Demographics
NPI:1952855256
Name:JSJ WELLNESS DIAGNOSTIC LABORATORY
Entity Type:Organization
Organization Name:JSJ WELLNESS DIAGNOSTIC LABORATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:STOECKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-786-7009
Mailing Address - Street 1:7707 FANNIN ST STE 205
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1968
Mailing Address - Country:US
Mailing Address - Phone:832-786-7009
Mailing Address - Fax:832-831-1579
Practice Address - Street 1:7707 FANNIN ST STE 205
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1968
Practice Address - Country:US
Practice Address - Phone:832-786-7009
Practice Address - Fax:832-831-1579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory