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Organization
PATHLAB INC
Active
Organization
PATHLAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAX MIROT M.D. (OWNER)
(520) 459-1984
Entity
Organization
Contact information
Practice address
4266 INDUSTRY DRIVE, SUITE 1, SIERRA VISTA, AZ 85635-2255
(520) 335-1800
(520) 335-2743
Mailing address
PO BOX 609, HEREFORD, AZ 85615-0609
(520) 335-1800
(520) 335-2743
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
AZ
291U00000X
Clinical Medical Laboratory
03D0713539
AZ
Other
Enumeration date
07/19/2013
Last updated
10/18/2016
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