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General NPI Number Information
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NPI Number | 1548488414
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Entity Type | Organization
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Legal Business Name | SCIENTIFIC LABORATORY DIVISION NMDOH
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 700 CAMINO DE SALUD
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-3740
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Country | US
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Telephone | 505-841-2500
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Fax | 505-841-2543
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Provider Business Mailing Address
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Address Line | 700 CAMINO DE SALUD NE P.O. BOX 4700
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City | ALBUQUERQUE
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State | NM
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Zip | 87196-4700
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Country | US
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Telephone | 505-841-2500
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Fax | 505-841-2543
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. DAVID MILLS
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Credential | PHD
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Telephone | 505-841-2500
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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 | NM
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