Healthcare Provider Details

I. General information

NPI: 1881404473
Provider Name (Legal Business Name): V & E LAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 TUSCAN RIDGE CIR
SANTA TERESA NM
88008-9808
US

IV. Provider business mailing address

102 TUSCAN RIDGE CIR
SANTA TERESA NM
88008-9808
US

V. Phone/Fax

Practice location:
  • Phone: 915-226-7501
  • Fax:
Mailing address:
  • Phone: 915-226-7501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247ZC0005X
TaxonomyClinical Laboratory Director (Non-physician)
License Number
License Number State

VIII. Authorized Official

Name: MS. SAHARAY GONZALEZ
Title or Position: PHLEBOTOMIST
Credential:
Phone: 915-226-7501