Provider First Line Business Practice Location Address:
1001 WOODWARD PLACE NE
Provider Second Line Business Practice Location Address:
TRICORE REFERENCE LABORATORIES
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87102-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-938-8465
Provider Business Practice Location Address Fax Number:
505-938-8414
Provider Enumeration Date:
08/02/2006