Organization
LAKE HAVASU MEDICAL LABORATORY,LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GWENNA J MARQUIS CLS(NCA) (PRESIDENT)
(928) 855-4077
Entity
Organization
Contact information
Practice address
1951 MESQUITE AVE, LAKE HAVASU CITY, AZ 86403-5746
(928) 855-4077
(928) 855-5470
Mailing address
1951 MESQUITE AVE, LAKE HAVASU CITY, AZ 86403-5746
(928) 855-4077
(928) 855-5470
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
AZ
Other
Enumeration date
12/27/2005
Last updated
08/22/2020
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