Provider Demographics
NPI:1922345560
Name:PATIENT'S CHOICE LAB SERVICES
Entity Type:Organization
Organization Name:PATIENT'S CHOICE LAB SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:PICCIRILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-923-0605
Mailing Address - Street 1:13236 N 7TH ST STE 4-245
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-5333
Mailing Address - Country:US
Mailing Address - Phone:602-923-0605
Mailing Address - Fax:602-314-5048
Practice Address - Street 1:3200 N DOBSON RD STE B-2
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-9608
Practice Address - Country:US
Practice Address - Phone:602-923-0605
Practice Address - Fax:602-314-5048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ03D1021408291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory