Provider Demographics
NPI:1356356026
Name:NORTH MOUNTAIN LABORATORY
Entity type:Organization
Organization Name:NORTH MOUNTAIN LABORATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CLARKE
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:LAMBE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-870-6375
Mailing Address - Street 1:8900 N CENTRAL AVE
Mailing Address - Street 2:STE. 103
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2845
Mailing Address - Country:US
Mailing Address - Phone:602-870-6375
Mailing Address - Fax:602-861-3500
Practice Address - Street 1:8900 N CENTRAL AVE
Practice Address - Street 2:STE. 103
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2845
Practice Address - Country:US
Practice Address - Phone:602-870-6375
Practice Address - Fax:602-861-3500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory