Organization
CENTRAL MEDICAL LABORATORY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN CHATFIELD HISERODT M.D. (MEDICAL DIRECTOR/ DIRECT OWNER)
(714) 743-5253
Entity
Organization
Contact information
Practice address
2601 N 3RD ST, SUITE# 218, PHOENIX, AZ 85004-1104
(602) 626-5360
(602) 626-5943
Mailing address
2601 N 3RD ST, SUITE# 218, PHOENIX, AZ 85004-1104
(602) 626-5360
(602) 626-5943
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
05/01/2013
Last updated
05/01/2013
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