Healthcare Provider Details

I. General information

NPI: 1114011806
Provider Name (Legal Business Name): SLIDE PROCESSING & REFERRAL LAB.,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1606 E CATALINA DR # 4
PHOENIX AZ
85016
US

IV. Provider business mailing address

1606 E CATALINA DR # 4
PHOENIX AZ
85016
US

V. Phone/Fax

Practice location:
  • Phone: 602-263-1101
  • Fax: 602-294-9018
Mailing address:
  • Phone: 602-263-1101
  • Fax: 602-294-9018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MS. CORDILLIA M ARREDONDO
Title or Position: OWNER
Credential:
Phone: 602-263-1101