Provider Demographics
NPI:1619788726
Name:HEALIX CLINICAL LABORATORY LLC
Entity type:Organization
Organization Name:HEALIX CLINICAL LABORATORY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-673-5917
Mailing Address - Street 1:4800 FOURNACE PL # BW3
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2324
Mailing Address - Country:US
Mailing Address - Phone:734-673-5917
Mailing Address - Fax:314-667-6915
Practice Address - Street 1:4800 FOURNACE PL # BW3
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2324
Practice Address - Country:US
Practice Address - Phone:734-673-5917
Practice Address - Fax:314-667-6915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory MedicineGroup - Single Specialty