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General NPI Number Information
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NPI Number | 1225523608
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Entity Type | Organization
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Legal Business Name | RED MOUNTAIN DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 06/27/2018
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Last Update Date | 08/14/2019
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Provider Practice Location Address
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Address Line | 140 OXMOOR BLVD STE 140
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City | HOMEWOOD
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State | AL
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Zip | 35209
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Country | US
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Telephone | 205-224-4490
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Fax | 205-224-4524
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Provider Business Mailing Address
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Address Line | 140 OXMOOR BLVD STE 140
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City | HOMEWOOD
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State | AL
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Zip | 35209-5985
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Country | US
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Telephone | 205-224-4490
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Fax | 205-224-4524
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KAREN LAKE
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Credential |
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Telephone | 205-313-4628
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State | AL
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