BRADSHAW MOUNTAIN DIAGNOSTIC LABORATORY INC.
NPI 1003802075
Clinical Medical Laboratory in Prescott, AZ

Active since September 23, 2005
990 WILLOW CREEK RD, PRESCOTT, AZ 86301(928) 778-7823(928) 778-9419 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Bradshaw Mountain Diagnostic Laboratory Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRADSHAW MOUNTAIN DIAGNOSTIC LABORATORY INC. (NPI 1003802075) is a healthcare organization registered as a clinical medical laboratory in Prescott, Arizona and active in the NPI registry since September 2005. The organization lists Tom Fellows, President, as its authorized official.

NPPES Registry Identity

NPI1003802075
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameBRADSHAW MOUNTAIN DIAGNOSTIC LABORATORY INC.
Location Address990 WILLOW CREEK RDPrescott, AZ 86301-1640
Mailing Address990 Willow Creek RdPrescott, AZ 86301-1640 · (928) 778-7823 · Fax (928) 778-9419
Fax(928) 778-9419
Organization SubpartNo
Authorized OfficialTom FellowsPresident · (928) 778-7823
Enumeration DateSeptember 23, 2005
Last NPPES UpdateAugust 22, 2020
NPI 1003802075 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
Definition
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
990 WILLOW CREEK RD, Prescott, AZ 86301

Other Identifiers 1

Medicaid050576AZ

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Social Worker (Clinical)
990 WILLOW CREEK RD
PRESCOTT, AZ 86301
Family Medicine
990 WILLOW CREEK RD
PRESCOTT, AZ 86301
Counselor (Professional)
990 WILLOW CREEK RD
PRESCOTT, AZ 86301
Psychiatry & Neurology (Psychiatry)
990 WILLOW CREEK RD
PRESCOTT, AZ 86301

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bradshaw Mountain Diagnostic Laboratory Inc.'s NPI number?

The NPI number for Bradshaw Mountain Diagnostic Laboratory Inc. is 1003802075. It was assigned to this organization in the NPPES registry on September 23, 2005.

Where is Bradshaw Mountain Diagnostic Laboratory Inc. located?

Bradshaw Mountain Diagnostic Laboratory Inc. is located at 990 Willow Creek Rd, Prescott, AZ 86301. The listed phone number is (928) 778-7823.

What is Bradshaw Mountain Diagnostic Laboratory Inc.'s specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

When was this NPI record last updated?

The NPPES record for Bradshaw Mountain Diagnostic Laboratory Inc. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.