Organization
SHASTA MEDICAL LAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWNA L SMITH (BILLING)
(530) 244-6716
Entity
Organization
Contact information
Practice address
1555 EAST ST, SUITE 300, REDDING, CA 96001-1153
(530) 242-4694
Mailing address
1555 EAST ST, SUITE 300, REDDING, CA 96001-1153
(530) 242-4694
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB66820F
—
CA
01
—
P00299430
MEDICARE RAILROAD
CA
Enumeration date
06/29/2007
Last updated
12/11/2007
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