Provider Demographics
NPI:1285448522
Name:DENA CLINICAL LABORATORY LLC
Entity type:Organization
Organization Name:DENA CLINICAL LABORATORY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEHRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAIDARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-630-3036
Mailing Address - Street 1:7676 HILLMONT ST STE 125
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-6474
Mailing Address - Country:US
Mailing Address - Phone:877-630-3036
Mailing Address - Fax:832-678-7126
Practice Address - Street 1:7676 HILLMONT ST STE 125
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040-6474
Practice Address - Country:US
Practice Address - Phone:877-630-3036
Practice Address - Fax:832-678-7126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory