Provider Demographics
NPI:1396520102
Name:AZM LABORATORIES LLC
Entity type:Organization
Organization Name:AZM LABORATORIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LABORATORY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VIOLET
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:512-760-4547
Mailing Address - Street 1:3610 SMITH BARRY RD STE 103
Mailing Address - Street 2:
Mailing Address - City:PANTEGO
Mailing Address - State:TX
Mailing Address - Zip Code:76013-4633
Mailing Address - Country:US
Mailing Address - Phone:512-760-4547
Mailing Address - Fax:214-722-2192
Practice Address - Street 1:3610 SMITH BARRY RD
Practice Address - Street 2:
Practice Address - City:PANTEGO
Practice Address - State:TX
Practice Address - Zip Code:76013-4640
Practice Address - Country:US
Practice Address - Phone:512-760-4547
Practice Address - Fax:214-722-2192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291900000XLaboratoriesMilitary Clinical Medical Laboratory