# PATHLAB INC

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

## Provider details

- **NPI number:** 1497197461
- **Authorized official:** MAX MIROT M.D. (OWNER)
- **Authorized official phone:** (520) 459-1984

## Contact information

- **Practice address:** 4266 INDUSTRY DRIVE, SUITE 1, SIERRA VISTA, AZ 85635-2255
- **Practice address phone:** (520) 335-1800
- **Practice address fax:** (520) 335-2743
- **Mailing address:** PO BOX 609, HEREFORD, AZ 85615-0609
- **Mailing address phone:** (520) 335-1800
- **Mailing address fax:** (520) 335-2743

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | AZ | Yes |
| 291U00000X | Clinical Medical Laboratory | 03D0713539 | AZ | — |

## Other

- **Enumeration date:** 07/19/2013
- **Last updated:** 10/18/2016