Organization
MONTE VISTA MEDICAL LABORATORY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY DEE CORDILL C.L.S. (SEC/TREAS)
(951) 652-4409
Entity
Organization
Contact information
Practice address
945 SAINT JOHN PL, HEMET, CA 92543-4421
(951) 652-4409
(951) 929-1443
Mailing address
945 SAINT JOHN PL, HEMET, CA 92543-4421
(951) 652-4409
(951) 929-1443
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF 3417
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ59449Z
—
CA
Enumeration date
02/09/2006
Last updated
08/22/2020
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