Organization
SOUTHWEST DIAGNOSTIC LABORATORIES PC
Active
Parent organization
AMERIPATH INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMERIPATH INC.
Authorized official
DR. EDWARD M KRAMER MD (VICE PRESIDENT)
(610) 550-3000
Entity
Organization
Contact information
Practice address
1010 THREE SPRINGS BLVD, DURANGO, CO 81301-8296
(970) 764-1170
(970) 764-1108
Mailing address
14275 MIDWAY RD, SUITE 400, ADDISON, TX 75001-3614
(214) 932-8029
(610) 271-4245
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
06D0518876
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04005880
—
CO
Enumeration date
02/03/2006
Last updated
04/24/2015
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