Organization
MOUNTAIN PEAKS DIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZACHARY LEE RUNYAN (CEO)
(719) 429-5076
Entity
Organization
Contact information
Practice address
502 GREENWOOD AVE, CANON CITY, CO 81212-3336
(719) 429-5076
Mailing address
818 FAIRVIEW AVE, CANON CITY, CO 81212-2858
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
10/28/2009
Last updated
10/28/2009
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