Organization
EL PASO PATHOLOGY LABORATORY LP
Active
Other names
PathLab Las Cruces
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD D FERNANDEZ MD (MEDCIAL DIRECTOR)
(505) 521-4819
Entity
Organization
Contact information
Practice address
4351 E LOHMAN AVE, #409, LAS CRUCES, NM 88011-8259
(505) 521-4819
(505) 556-6709
Mailing address
4351 E LOHMAN AVE, #409, LAS CRUCES, NM 88011-8259
(505) 521-4819
(505) 556-6709
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1677932
—
TX
05
—
77323815
—
NM
01
—
CL5126
BLUE CROSS BLUE SHIELD TE
TX
Enumeration date
11/08/2006
Last updated
08/22/2020
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