Organization
1 SOURCE LABS AND MEDICAL SERVICES LLC
Active
Organization
1 SOURCE LABS AND MEDICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MANUEL ENRIQUE SALGADO (CEO)
(623) 261-1716
Entity
Organization
Contact information
Practice address
2440 W MISSION LN STE 5, PHOENIX, AZ 85021-2824
(623) 261-1716
(623) 321-1569
Mailing address
2440 W MISSION LN STE 5, PHOENIX, AZ 85021-2824
(623) 261-1716
(623) 321-1569
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
04/16/2020
Last updated
04/16/2020
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