Provider Demographics
NPI:1982071098
Name:MEDSCOPE LABORATORIES,LLC
Entity Type:Organization
Organization Name:MEDSCOPE LABORATORIES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:M
Authorized Official - Middle Name:HARROON
Authorized Official - Last Name:MALIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-703-3999
Mailing Address - Street 1:2122 W LONE CACTUS DR
Mailing Address - Street 2:SUITE 11
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-2650
Mailing Address - Country:US
Mailing Address - Phone:480-639-7806
Mailing Address - Fax:
Practice Address - Street 1:2122 W LONE CACTUS DR
Practice Address - Street 2:SUITE 11
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-2650
Practice Address - Country:US
Practice Address - Phone:480-639-7806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ03D2085583291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory