Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bradshaw Mountain Diagnostic Laboratory Inc

Organization Clinical Medical Laboratory · NPI 1508012253

Bradshaw Mountain Diagnostic Laboratory Inc is a Clinical Medical Laboratory in Wickenburg, Arizona. Registered with an NPI since 2008.

In the registry since
2008
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

579 W Wickenburg Way #8
Wickenburg, AZ 85390-4300
Phone: (928) 684-0332
Fax: (928) 684-0537
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Medical Laboratory (primary) Taxonomy 291U00000X

Record details

NPI number1508012253
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationBradshaw Mountain Diagnostic Laboratory Inc
Authorized official Tom Fellows — President · (928) 778-7823
NPI enumeratedAugust 13, 2008
Last updated in NPPESAugust 13, 2008
Mailing address990 Willow Creek Rd, Prescott, AZ 86301-1640

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