Organization
MEMPHIS PATHOLOGY LABORATORY
Active
Other names
American Esoteric Laboratories
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DINA VALLADARES (SENIOR DIRECTOR)
(954) 803-9405
Entity
Organization
Contact information
Practice address
1701 CENTURY CENTER CV, MEMPHIS, TN 38134-8975
(901) 405-8200
(901) 328-3882
Mailing address
1701 CENTURY CENTER CV, MEMPHIS, TN 38134-8975
(901) 405-8200
(901) 525-5465
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
0000002069
TN
291U00000X
Clinical Medical Laboratory
0000003251
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0121666
—
MS
05
—
139749709
—
AR
01
—
3138591
BLUE CROSS
TN
05
—
3403482
—
TN
05
—
7100113940
—
KY
Enumeration date
08/30/2006
Last updated
12/19/2025
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