Provider Demographics
NPI:1265322317
Name:AUXILIUM DIAGNOSTICS LLC
Entity type:Organization
Organization Name:AUXILIUM DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:GUILLORY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:346-440-2751
Mailing Address - Street 1:7035 W TIDWELL RD STE J-100A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-2054
Mailing Address - Country:US
Mailing Address - Phone:346-440-2751
Mailing Address - Fax:
Practice Address - Street 1:7035 W TIDWELL RD STE J-100A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-2054
Practice Address - Country:US
Practice Address - Phone:346-440-2751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-08
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory