Organization
CUTTING EDGE HISTOLOGY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. M VINCENT MESA D.O. (PRESIDENT)
(503) 268-4805
Entity
Organization
Contact information
Practice address
8192 SW DURHAM RD, TIGARD, OR 97224-7315
(503) 268-4805
(503) 268-4801
Mailing address
PO BOX 4207, PORTLAND, OR 97208-4207
(503) 268-4805
(503) 268-4801
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227673
—
OR
Enumeration date
04/03/2008
Last updated
05/07/2010
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