Organization
HIGH DESERT DIAGNOSTIC LABORATORY
Active
Organization
HIGH DESERT DIAGNOSTIC LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS C FELLOWS (PRESIDENT)
(928) 713-1290
Entity
Organization
Contact information
Practice address
1003 DIVISION ST, SUITE 5, PRESCOTT, AZ 86301-1657
(928) 445-0103
(928) 445-1032
Mailing address
1003 DIVISION ST, SUITE 3, PRESCOTT, AZ 86301-1657
(928) 445-0103
(928) 445-1032
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
03D2075971
AZ
Other
Enumeration date
04/15/2014
Last updated
04/15/2014
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