Organization
MAHARLIKA MEDICAL LABORATORY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHNNIE LEWIS ADAMS MS (CHAIRMAN)
(559) 233-6242
Entity
Organization
Contact information
Practice address
1350 O ST STE 101, FRESNO, CA 93721-1828
(559) 233-6242
(559) 233-6243
Mailing address
PO BOX 2032, FRESNO, CA 93718-2032
(559) 233-6242
(559) 233-6243
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF4565
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB58481F
—
CA
Enumeration date
05/31/2005
Last updated
09/25/2007
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