Organization
PROSTATE DIAGNOSTICS, LLC
Active
Organization
PROSTATE DIAGNOSTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BOAZ LERER (MANAGING MEMBER)
(602) 368-8001
Entity
Organization
Contact information
Practice address
16601 N 40TH ST, SUITE 222, PHOENIX, AZ 85032-3345
(602) 368-8001
(602) 368-1386
Mailing address
4245 E DANBURY RD, PHOENIX, AZ 85032-9204
(602) 788-7814
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
03D1098706
AZ
Other
Enumeration date
04/19/2009
Last updated
03/19/2015
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