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General NPI Number Information
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NPI Number | 1306768858
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Entity Type | Organization
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Legal Business Name | METIRRA PATHOLOGY PC
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Dates
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Enumeration Date | 07/27/2026
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Last Update Date | 07/27/2026
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Provider Practice Location Address
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Address Line | 10128 W BROAD ST STE H
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City | GLEN ALLEN
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State | VA
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Zip | 23060-6761
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Country | US
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Telephone | 949-616-2809
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Fax |
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Provider Business Mailing Address
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Address Line | 2889 W ASHTON BLVD STE 300
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City | LEHI
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State | UT
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Zip | 84048-4968
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Country | US
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Telephone | 949-616-2809
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Fax |
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Authorized Official
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Title or Position | EVP COMMERCIAL
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Name | EDWIN C HENDRICK
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Credential |
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Telephone | 949-616-2809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZC0006X
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Taxonomy Name | Clinical Pathology Physician
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License Number |
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License Number State |
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