Organization
ADVANCED MEDICAL LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NOMAN WAKED PHD (LABORATORY MANAGER)
(928) 344-8525
Entity
Organization
Contact information
Practice address
2435 S AVENUE A, SUITE 4, YUMA, AZ 85364-7175
(928) 344-8525
(928) 726-3434
Mailing address
PO BOX 4548, YUMA, AZ 85366-4548
(928) 344-8525
(928) 726-3434
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
L325PVL
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0336330
BLUE CROSS OF ARIZONA
AZ
Enumeration date
08/25/2006
Last updated
10/04/2007
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