Provider Demographics
NPI:1134450703
Name:LONE STAR DIAGNOSTICS
Entity type:Organization
Organization Name:LONE STAR DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:METCALFE
Authorized Official - Suffix:
Authorized Official - Credentials:RPSGT
Authorized Official - Phone:915-538-7117
Mailing Address - Street 1:4625 ALABAMA ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79930-2517
Mailing Address - Country:US
Mailing Address - Phone:915-538-7117
Mailing Address - Fax:915-208-4037
Practice Address - Street 1:4625 ALABAMA ST
Practice Address - Street 2:SUITE B
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79930-2517
Practice Address - Country:US
Practice Address - Phone:915-538-7117
Practice Address - Fax:915-208-4037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory