Organization
MEDIVA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUKESH MUKESH (OWNER)
(929) 410-5754
Entity
Organization
Contact information
Practice address
5802 W SAMPLE AVE, FRESNO, CA 93722-3153
(929) 410-5754
Mailing address
5802 W SAMPLE AVE, FRESNO, CA 93722-3153
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
10/29/2025
Last updated
12/02/2025
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