# PHOENIX CLINICAL LABS INC

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

## Provider details

- **NPI number:** 1164677423
- **Authorized official:** TARIK M ELSHEIKH (PRESIDENT)
- **Authorized official phone:** (317) 748-9743

## Contact information

- **Practice address:** 8755 GUION RD, INDIANAPOLIS, IN 46268-3047
- **Practice address phone:** (317) 748-9743
- **Mailing address:** 12115 MAGNOLIA BLVD, SUITE 324, N HOLLYWOOD, CA 91607-2609

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | 01046076A | IN | Yes |

## Other

- **Enumeration date:** 11/28/2008
- **Last updated:** 12/15/2008