Organization
WESTERN DIAGNOSTIC SERVICES LABORATORY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN FERGUSON MD (PRESIDENT)
(805) 548-1550
Entity
Organization
Contact information
Practice address
1414 E MAIN ST, SUITE 102, SANTA MARIA, CA 93454-4806
(805) 548-1550
Mailing address
PO BOX 5057, SAN LUIS OBISPO, CA 93403-5057
(805) 242-1789
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
12/14/2015
Last updated
09/07/2023
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