Organization
MGA LAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LUCIO N MARGALLO II MD (PHYSICIAN)
(605) 996-5553
Entity
Organization
Contact information
Practice address
1115 EAST 5TH, MITCHELL, SD 57301-1003
(605) 996-5553
Mailing address
1115 E 5TH AVE, MITCHELL, SD 57301-2917
(605) 996-5553
(605) 996-5553
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5585070
—
SD
Enumeration date
09/05/2006
Last updated
12/13/2010
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