Contract Details
Ancillary Care Services
Facility name
Premier Labs
Provider ID
P000004391
NPI
1376854299
Tax ID
271372618
Effective Date
4/1/2012
Last Updated
10/28/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
12060 Bellaire Boulevard Suite F
Houston, TX 77072
United States
County
Harris
Phone
2819884500 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Laboratory Service Provider
Map
Address