OrganizationActive
Bradshaw Mountain Diagnostic Laboratory Inc
NPI 1508012253 · Clinical Medical Laboratory · Wickenburg, AZ
Provider details
- NPI number
- 1508012253
- Entity type
- Organization
- Primary specialty
- Clinical Medical LaboratoryLaboratories
- Parent organization
- Bradshaw Mountain Diagnostic Laboratory Inc
- Organization subpart
- Yes
- Authorized official
- Tom Fellows, President(928) 778-7823
Specialties & taxonomies
Laboratories
Practice location
579 W Wickenburg Way
#8
Wickenburg, AZ 85390-4300
Phone: (928) 684-0332
Fax: (928) 684-0537
Approximate (ZIP-level) locationGet directions
Mailing address
990 Willow Creek Rd
Prescott, AZ 86301-1640
Registry dates
- Enumerated
- 2008-08-13
- Last updated
- 2008-08-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.