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Organization

CLIN-PATH DIAGNOSTICS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROBERT DE LA TORRE (C.O.O.)
(602) 685-5211
Entity
Organization

Contact information

Practice address
2109 S. 48TH STREET, SUITE 102, TEMPE, AZ 85282
(602) 424-2889
(602) 424-2569
Mailing address
PO BOX 42210, PHOENIX, AZ 85080
(623) 889-7403
(623) 889-7407

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
AZ
291U00000X
Clinical Medical Laboratory

Other

Enumeration date
07/02/2006
Last updated
12/18/2013
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