Texas Clinical Laboratory LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

TEXAS CLINICAL LABORATORY LLC

Practice address

6130 Montana Ave Ste 217
El Paso, TX 79925-2047

Phone

(512) 768-5058

Fax

(254) 765-2267

NPI assigned

Jul 22, 2024

Last updated

Aug 5, 2025By 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

Ambreen Khan

Title

Owner

Phone

(512) 768-5058

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754352000000",
    "number": "1023846169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6130 MONTANA AVE STE 217",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799252047",
            "telephone_number": "512-768-5058",
            "fax_number": "254-765-2267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6130 MONTANA AVE STE 217",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799252047",
            "telephone_number": "512-768-5058",
            "fax_number": "254-765-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS CLINICAL LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-22",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "AMBREEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-768-5058"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.