Organization
COUNTY OF FRESNO
Active
Other names
Department of Public Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID POMAVILLE M.B.A., R.E.H.S. (DIRECTOR)
(559) 600-3200
Entity
Organization
Contact information
Practice address
1221 FULTON MALL, PUBLIC HEALTH LAB, BASEMENT, FRESNO, CA 93721-1915
(559) 600-3200
(559) 600-7687
Mailing address
PO BOX 11867, PUBLIC HEALTH LAB, BASEMENT, FRESNO, CA 93775-1867
(559) 600-3200
(559) 600-7687
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
341
CHDP BLUE CROSS
CA
01
—
351
CHDP HEALTH NET
CA
01
—
LAB89686F
LAB CHDP
CA
01
—
ZZZ83427Z
MEDI-CAL
CA
Enumeration date
10/19/2006
Last updated
05/16/2014
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