| NPI | 1114996667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY DAVID KHACHATURIAN Business Manager 480-922-4923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AZ 03D1074399 CLIA) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AZ 13453 State License) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2016-11-03 |