Organization
SOUTHWEST SKIN LABORATORY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW TRAVIS WOODS MD (OWNER)
(480) 855-0085
Entity
Organization
Contact information
Practice address
1684 E BOSTON ST, STE 105, GILBERT, AZ 85295-6219
(480) 855-0085
(480) 855-0086
Mailing address
1688 E BOSTON ST STE 101, GILBERT, AZ 85295-6222
(480) 855-0085
(480) 855-0086
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
03D2046062
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
757609
—
AZ
Enumeration date
04/30/2012
Last updated
03/07/2024
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