# CERVIOM LLC

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

## Provider details

- **NPI number:** 1972788818
- **Authorized official:** ADRIAN C PANTHER (OWNER)
- **Authorized official phone:** (720) 308-4567

## Contact information

- **Practice address:** 15047 W 54TH DR, GOLDEN, CO 80403-2915
- **Practice address phone:** (281) 462-1285
- **Practice address fax:** (281) 462-1554
- **Mailing address:** PO BOX 1288, CROSBY, TX 77532-1288
- **Mailing address phone:** (281) 462-1285
- **Mailing address fax:** (281) 462-1554

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 293D00000X | Physiological Laboratory | — | — | Yes |

## Other

- **Enumeration date:** 01/09/2008
- **Last updated:** 01/09/2008