Provider Demographics
NPI:1841367620
Name:ENVIRO HEALTH SYSTEMS INC.
Entity type:Organization
Organization Name:ENVIRO HEALTH SYSTEMS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LABORATORY DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:LASETER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:972-234-5412
Mailing Address - Street 1:990 N BOWSER RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-2896
Mailing Address - Country:US
Mailing Address - Phone:972-234-5412
Mailing Address - Fax:972-234-6095
Practice Address - Street 1:990 N BOWSER RD
Practice Address - Street 2:SUITE 800
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-2896
Practice Address - Country:US
Practice Address - Phone:972-234-5412
Practice Address - Fax:972-234-6095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45DO477860OtherCLIA
TXCL0561Medicare ID - Type Unspecified