# PETROGLYPH PATHOLOGY SERVICES, LLC

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

## Provider details

- **NPI number:** 1801003231
- **Authorized official:** MS. SANDRA M MUELLER M.D. (PATHOLOGIST)
- **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
- **Practice address fax:** (505) 924-0210
- **Mailing address:** 640 QUANTUM RD NE, RIO RANCHO, NM 87124-4506
- **Mailing address phone:** (505) 924-0209
- **Mailing address fax:** (505) 924-0210

## Taxonomy

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

## Other

- **Enumeration date:** 05/16/2007
- **Last updated:** 10/02/2014