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General NPI Number Information
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NPI Number | 1649367368
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Entity Type | Organization
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Legal Business Name | PHYSICIANS LABORATORIES, INC
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4900 MILL ST STE 10A
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City | RENO
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State | NV
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Zip | 89502-2391
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Country | US
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Telephone | 775-856-3667
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Fax | 775-856-3668
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Provider Business Mailing Address
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Address Line | 4900 MILL ST STE 10A
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City | RENO
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State | NV
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Zip | 89502-2391
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Country | US
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Telephone | 775-856-3667
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Fax | 775-856-3668
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Authorized Official
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Title or Position | OWNER
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Name | MRS. PACITA MANALO
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Credential | MD
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Telephone | 775-856-3667
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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 | NV
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