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Organization

MARIN MEDICAL LABORATORIES

Active
Other names
Marin Medical Laboratories
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PAUL WILLIAM WASSERSTEIN MD (MANAGING PARTNER)
(415) 925-7174
Entity
Organization

Contact information

Practice address
1615 HILL ROAD, SUITE B, NOVATO, CA 94947
(415) 898-7649
(415) 898-0870
Mailing address
1615 HILL ROAD, SUITE B, NOVATO, CA 94947
(415) 898-7649
(415) 898-0870

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
CLF789
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05D0663150
CLIA
01
CLF789
STATE LICENSE
05
LAB63150F
CA
Enumeration date
09/15/2006
Last updated
10/23/2007
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