# PETROGLYPH PATHOLOGY SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033501747
- **Authorized official:** DAVID ROWE (LAB MANAGER)
- **Authorized official phone:** (505) 924-0209

## Contact information

- **Practice address:** 640 QUANTUM RD NE, RIO RANCHO, NM 87124-4506
- **Practice address phone:** (505) 924-0209
- **Mailing address:** 640 QUANTUM RD NE, RIO RANCHO, NM 87124-4506
- **Mailing address phone:** (505) 924-0209

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | 2002-0204 | NM | Yes |

## Other

- **Enumeration date:** 03/04/2015
- **Last updated:** 04/18/2018