Provider Demographics
NPI:1750977005
Name:STAT LABS, LLC
Entity type:Organization
Organization Name:STAT LABS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DUSEK
Authorized Official - Suffix:
Authorized Official - Credentials:LNFA
Authorized Official - Phone:713-553-1321
Mailing Address - Street 1:15101 W FM 2147
Mailing Address - Street 2:
Mailing Address - City:HORSESHOE BAY
Mailing Address - State:TX
Mailing Address - Zip Code:78657-2168
Mailing Address - Country:US
Mailing Address - Phone:713-553-1321
Mailing Address - Fax:
Practice Address - Street 1:15101 W FM 2147
Practice Address - Street 2:
Practice Address - City:HORSESHOE BAY
Practice Address - State:TX
Practice Address - Zip Code:78657-2168
Practice Address - Country:US
Practice Address - Phone:713-553-1321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-20
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory