# PROFESSIONAL MEDICAL LABORATORY SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467861302
- **Authorized official:** STEPHEN CONNOLLY M.D. (PRESIDENT)
- **Authorized official phone:** (209) 467-6491

## Contact information

- **Practice address:** 1800 N CALIFORNIA ST, STOCKTON, CA 95204-6019
- **Practice address phone:** (209) 476-6491
- **Practice address fax:** (209) 461-5492
- **Mailing address:** 5700 SOUTHWYCK BLVD, TOLEDO, OH 43614-1509
- **Mailing address phone:** (800) 288-8325
- **Mailing address fax:** (419) 866-5453

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/05/2014
- **Last updated:** 08/05/2014