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Organization

TRICORE REFERENCE LABORATORIES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL CROSSEY MD (CEO)
(505) 938-8888
Entity
Organization

Contact information

Practice address
1001 WOODWARD PL NE, ALBUQUERQUE, NM 87102-2705
(505) 938-8888
(505) 938-8833
Mailing address
1001 WOODWARD PL NE, ATTENTION: BUSINESS OFFICE, ALBUQUERQUE, NM 87102-2705
(505) 938-8888
(505) 938-8833

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000L0628
NM
05
004388300
NV
05
073041801
TX
05
119530100
WY
05
191050000
ME
05
200049370A
OK
05
627375
AZ
01
690008077
RAILROAD MEDICARE
05
806981000
ID
05
98003643
CO
Enumeration date
11/28/2006
Last updated
02/14/2020
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