Organization Active NPI

Heritage Laboratory Systems, LLC

  • Clinical Medical Laboratory
  • Forney, TX
National Provider Identifier
1659660223
Registry record updated Apr 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
HERITAGE LABORATORY SYSTEMS, LLC
Practice address
763 E US Highway 80
Suite 260
Forney, TX 75126-8633
Phone
(214) 244-6547
Fax
(469) 548-6837
NPI assigned
Apr 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2011

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

Authorized official

Name
Mr. Raymond Eugene Davis Jr.
Title
Ceo/President
Phone
(214) 244-6547

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

763 E US Highway 80
Suite 260
Forney, TX 75126-8633

Mailing address

4010 Heavenly Way
Heartland, TX 75126-8269
Phone (214) 244-6547

National Provider Directory

National Provider Directory

Locations

15330 Lyndon B Johnson Fwy
Ste 301
Mesquite, TX 75150
Phone (214) 244-6547

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301875200000",
    "number": "1659660223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 HEAVENLY WAY",
            "city": "HEARTLAND",
            "state": "TX",
            "postal_code": "751268269",
            "telephone_number": "214-244-6547",
            "fax_number": "469-548-6837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "763 E US HIGHWAY 80",
            "address_2": "SUITE 260",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751268633",
            "telephone_number": "214-244-6547",
            "fax_number": "469-548-6837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE LABORATORY SYSTEMS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-04",
        "last_updated": "2011-04-04",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "214-244-6547",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forney, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; 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.