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Organization

PROFESSIONAL MEDICAL LABORATORY SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEPHEN CONNOLLY M.D. (PRESIDENT)
(209) 467-6491
Entity
Organization

Contact information

Practice address
1800 N CALIFORNIA ST, STOCKTON, CA 95204-6019
(209) 476-6491
(209) 461-5492
Mailing address
5700 SOUTHWYCK BLVD, TOLEDO, OH 43614-1509
(800) 288-8325
(419) 866-5453

Taxonomy

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

Other

Enumeration date
08/05/2014
Last updated
08/05/2014
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