Organization
MAGNOLIA DIAGNOSTIC CENTER,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAMON GUTIERREZ (PRESIDENT)
(509) 389-9765
Entity
Organization
Contact information
Practice address
2100 N DR MARTIN LUTHER KING JR BLVD, CLOVIS, NM 88101-9412
(509) 389-9765
(505) 213-0132
Mailing address
2100 N DR MARTIN LUTHER KING JR BLVD, CLOVIS, NM 88101-9412
(509) 389-9765
(505) 213-0132
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
NM
Other
Enumeration date
11/08/2006
Last updated
08/22/2020
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