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Contact Information

MAGNOLIA DIAGNOSTIC CENTER,INC
2100 N DR MARTIN LUTHER KING JR BLVD
CLOVIS, NM88101-9412
 Phone: 509-389-9765
 Fax: 505-213-0132
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical Medical Laboratory

291U00000X 69 Clinical Laboratory
Indicates primary specialty

NPI Profile & details for MAGNOLIA DIAGNOSTIC CENTER,INC

NPI # 1710057740
LBN Legal business name MAGNOLIA DIAGNOSTIC CENTER,INC
Authorized official RAMON GUTIERREZ - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 11/08/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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