Organization
COMMUNITY MEDICAL LABORATORY, LLC
Active
Other names
Community Medical Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
JULIA A PORTER (MEMBER)
(928) 733-6170
Entity
Organization
Contact information
Practice address
1695 MESQUITE AVE STE 202, LAKE HAVASU CITY, AZ 86403-5687
(928) 733-6170
Mailing address
1695 MESQUITE AVE STE 202, LAKE HAVASU CITY, AZ 86403-5687
(928) 733-6170
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
03D2115501
—
Other
Enumeration date
08/06/2016
Last updated
08/06/2016
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