Southwest Skin Laboratory Pllc

LBN: Southwest Skin Laboratory Pllc
Southwest Skin Laboratory Pllc is an health care organization with primary practice located at 1684 E Boston St Ste 105, Gilbert AZ 85295-6219. The organization recently has only one registered license in Laboratories / Clinical Medical Laboratory, which is considered as the primary health care specialty. Southwest Skin Laboratory Pllc can be contacted via phone (480) 855-0085, or through Woods, Matthew Travis via phone (480) 855-0085.

Contact Information

Primary practice address
1684 E Boston St Ste 105 Gilbert AZ 85295-6219
Fax: (480) 855-0086
Website:
Authorized official contact:
Name: Woods, Matthew Travis Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Laboratories / Clinical Medical Laboratory 291U00000X 03D2046062 Arizona

Profile Details

NPI number 1124386966
LBN Legal business name Southwest Skin Laboratory Pllc
DBA Doing business as
Authorized official Woods, Matthew Travis Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 30th, 2012
Last updated Mar 7th, 2024 - about 8 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124386966 NPPES
Arizona MEDICAID 757609

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