Organization
COUNTY OF SANTA CRUZ
Active
Parent organization
THE COUNTY OF SANTA CRUZ
Other names
Health Services Agency Watsonville Health Center Laboratory
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE COUNTY OF SANTA CRUZ
Authorized official
MS. AMY PEELER (CHIEF OF CLINICS)
(831) 454-4764
Entity
Organization
Contact information
Practice address
1430 FREEDOM BLVD, LABORATORY, WATSONVILLE, CA 95076-2780
(831) 763-8173
(831) 763-8237
Mailing address
1430 FREEDOM BLVD, LABORATORY, WATSONVILLE, CA 95076-2780
(831) 763-8173
(831) 763-8237
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
04130F
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0875212
CMS CLIA
—
01
—
BQ985
MEDICARE PTAN
CA
01
—
CA154566
MEDICARE PTAN
CA
01
—
HAP70044F
CA. FAMILY PLANNING
CA
05
—
LAB04130F
—
CA
01
—
ZZZ95051Z
MEDICARE PTAN
CA
Enumeration date
02/06/2007
Last updated
11/28/2023
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