Healthcare Provider Details

I. General information

NPI: 1972637817
Provider Name (Legal Business Name): HEMEX LABORATORIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 W BERYL AVE
PHOENIX AZ
85021-1641
US

IV. Provider business mailing address

2505 W BERYL AVE
PHOENIX AZ
85021-1641
US

V. Phone/Fax

Practice location:
  • Phone: 602-997-9161
  • Fax: 602-997-1406
Mailing address:
  • Phone: 602-997-9161
  • Fax: 602-997-1406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. DAVID E BERG
Title or Position: LLC MANAGER
Credential: MS
Phone: 602-997-9161