Organization
MEDICAL LABORATORY SPECIALTY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAHAN FERDOUS (DIRECTOR)
(480) 703-4227
Entity
Organization
Contact information
Practice address
3636 ST, KINGMAN, AZ 86409
(928) 757-3636
Mailing address
529 W COLGATE DR, TEMPE, AZ 85283-1753
(480) 703-4227
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
03D2120368
—
Other
Enumeration date
01/10/2017
Last updated
01/10/2017
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