Organization
COUNTY OF MENDOCINO
Active
Other names
LAB
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN COMB (LAB MANAGER)
(707) 463-4145
Entity
Organization
Contact information
Practice address
501 LOW GAP RD, BASEMENT, UKIAH, CA 95482-3738
(707) 463-4145
Mailing address
501 LOW GAP RD, BASEMENT, UKIAH, CA 95482-3738
(707) 463-4145
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LAB5859AF
PH MEDICAL LAB #
CA
Enumeration date
01/31/2007
Last updated
08/22/2020
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