Provider Demographics
NPI:1851545685
Name:USA HCG REFERENCE SERVICE
Entity Type:Organization
Organization Name:USA HCG REFERENCE SERVICE
Other - Org Name:USA HCG REFERENCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LAB DIRECTOR/PROFESSOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:505-272-6137
Mailing Address - Street 1:MSC10 5580
Mailing Address - Street 2:DEPT OF OB/GYN
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:505-272-6137
Mailing Address - Fax:505-272-3576
Practice Address - Street 1:915 CAMINO DE SALUD
Practice Address - Street 2:BMSB ROOM G64
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-6137
Practice Address - Fax:505-272-3576
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF NEW MEXICO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-06
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
32D0972561OtherCLIA LABORATORY CERTIFICATION