OrganizationActive
Bradshaw Mountain Diagnostic Laboratory Inc.
NPI 1003802075 · Clinical Medical Laboratory · Prescott, AZ
Provider details
- NPI number
- 1003802075
- Entity type
- Organization
- Primary specialty
- Clinical Medical LaboratoryLaboratories
- Organization subpart
- No
- Authorized official
- Tom Fellows, President(928) 778-7823
Specialties & taxonomies
Laboratories
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
990 Willow Creek Rd
Prescott, AZ 86301-1640
Phone: (928) 778-7823
Fax: (928) 778-9419
Street-level locationGet directions
Mailing address
990 Willow Creek Rd
Prescott, AZ 86301-1640
Registry dates
- Enumerated
- 2005-09-23
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.