Companion DX Reference Lab, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

45D2034771 Issued in TX

Legal business name

COMPANION DX REFERENCE LAB, LLC

Practice address

10301 Stella Link Rd Ste C
Houston, TX 77025-5447

Phone

(832) 538-1600

Fax

(832) 538-1601

NPI assigned

Mar 8, 2012

Last updated

Oct 6, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Steve J Blum

Title

Ceo-Cfo

Phone

(832) 867-6008

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1331164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412553600000",
    "number": "1003180027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10301 STELLA LINK RD STE C",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770255447",
            "telephone_number": "832-538-1600",
            "fax_number": "832-538-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10301 STELLA LINK RD STE C",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770255447",
            "telephone_number": "832-538-1600",
            "fax_number": "832-538-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPANION DX REFERENCE LAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-08",
        "last_updated": "2014-10-06",
        "status": "A",
        "authorized_official_last_name": "BLUM",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO-CFO",
        "authorized_official_telephone_number": "832-867-6008",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TX",
            "license": "45D2034771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Houston, TX
• Providers in Houston, TX by specialty
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.