Organization
C-B LABORATORY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH K VANCE MT (PRESIDENT / OWNER)
(575) 622-1972
Entity
Organization
Contact information
Practice address
313 W COUNTRY CLUB RD, STE 8, ROSWELL, NM 88201-5804
(575) 622-1972
(575) 622-2820
Mailing address
313 W COUNTRY CLUB RD, STE 8, ROSWELL, NM 88201-5804
(575) 622-1972
(575) 622-2820
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00052589
—
NM
01
—
00NM005258
BCBS
—
01
—
690417029
RR MED
—
Enumeration date
11/14/2006
Last updated
07/28/2008
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