Organization
PHAROS DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL BERGTHOLD (PRESIDENT AND CEO)
(602) 885-3795
Entity
Organization
Contact information
Practice address
3814 E 5TH ST, TUCSON, AZ 85716-5145
(520) 355-4500
Mailing address
3830 VALLEY CENTRE DR, STE 705 PMB514, SAN DIEGO, CA 92130-3307
(520) 355-2500
(855) 875-6727
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
03D2120595
AZ
Other
Enumeration date
11/08/2016
Last updated
07/17/2019
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