Healthcare Provider Details

I. General information

NPI: 1356356026
Provider Name (Legal Business Name): NORTH MOUNTAIN LABORATORY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 N CENTRAL AVE STE. 103
PHOENIX AZ
85020-2845
US

IV. Provider business mailing address

8900 N CENTRAL AVE STE. 103
PHOENIX AZ
85020-2845
US

V. Phone/Fax

Practice location:
  • Phone: 602-870-6375
  • Fax: 602-861-3500
Mailing address:
  • Phone: 602-870-6375
  • Fax: 602-861-3500

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: DR. CLARKE DAVID LAMBE
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 602-870-6375