Provider Demographics
NPI:1174194682
Name:LEAN LABS MEDICAL SERVICES
Entity type:Organization
Organization Name:LEAN LABS MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELDER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:210-874-5326
Mailing Address - Street 1:4334 N LOOP 1604 W STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-3485
Mailing Address - Country:US
Mailing Address - Phone:210-874-5326
Mailing Address - Fax:210-874-5327
Practice Address - Street 1:4334 N LOOP 1604 W STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-3485
Practice Address - Country:US
Practice Address - Phone:210-874-5326
Practice Address - Fax:210-874-5327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center