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Organization

INTEGRATED MOLECULAR DIAGNOSTICS PATHOLOGY, INC.

Active
Other names
IMD Path
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ISRAEL VILLASENSOR (EXECUTIVE VICE PRESIDENT/SECRETARY)
(831) 818-4051
Entity
Organization

Contact information

Practice address
12635 E MONTVIEW BLVD, STE 360, AURORA, CO 80045-7335
(303) 961-1773
(866) 550-3288
Mailing address
1900 THE ALAMEDA, STE 530, SAN JOSE, CA 95126-1437
(831) 818-4051
(866) 550-3288

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
195377
CO
291U00000X
Clinical Medical Laboratory
Primary

Other

Enumeration date
03/25/2015
Last updated
01/25/2017
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