Healthcare Provider Details

I. General information

NPI: 1851545685
Provider Name (Legal Business Name): USA HCG REFERENCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2008
Last Update Date: 03/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 CAMINO DE SALUD BMSB ROOM G64
ALBUQUERQUE NM
87131-0001
US

IV. Provider business mailing address

MSC10 5580 DEPT OF OB/GYN
ALBUQUERQUE NM
87131-0001
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-6137
  • Fax: 505-272-3576
Mailing address:
  • Phone: 505-272-6137
  • Fax: 505-272-3576

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. LAURENCE ANTHONY COLE
Title or Position: LAB DIRECTOR/PROFESSOR
Credential: PHD
Phone: 505-272-6137