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General NPI Number Information
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NPI Number | 1548370745
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Entity Type | Organization
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Legal Business Name | MEMPHIS PATHOLOGY LABORATORY
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 1701 CENTURY CENTER CV
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City | MEMPHIS
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State | TN
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Zip | 38134-8975
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Country | US
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Telephone | 901-405-8200
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Fax | 901-328-3882
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Provider Business Mailing Address
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Address Line | 1701 CENTURY CENTER CV
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City | MEMPHIS
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State | TN
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Zip | 38134-8975
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Country | US
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Telephone | 901-405-8200
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Fax | 901-525-5465
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Authorized Official
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Title or Position | SENIOR DIRECTOR
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Name | MRS. DINA VALLADARES
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Credential |
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Telephone | 954-803-9405
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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 | 0000003251
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 0000002069
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License Number State | TN
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