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Organization
SOUTHWEST DIAGNOSTIC LABORATORIES PC
Active
Organization
SOUTHWEST DIAGNOSTIC LABORATORIES PC
Active
Parent organization
AMERIPATH INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMERIPATH INC.
Authorized official
DR. EDWARD M KRAMER MD (VICE PRESIDENT)
(610) 550-3000
Entity
Organization
Contact information
Practice address
1010 THREE SPRINGS BLVD, DURANGO, CO 81301-8296
(970) 764-1170
(970) 764-1108
Mailing address
14275 MIDWAY RD, SUITE 400, ADDISON, TX 75001-3614
(214) 932-8029
(610) 271-4245
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
06D0518876
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04005880
—
CO
Enumeration date
02/03/2006
Last updated
04/24/2015
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