Organization
MICROTECHNICAL LABORATORY
Active
Organization
MICROTECHNICAL LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON ROGER DUNHAM H.T. (ASCP) (OWNER)
(909) 478-1025
Entity
Organization
Contact information
Practice address
11175 MOUNTAIN VIEW AVE, SUITE K, LOMA LINDA, CA 92354-3865
(909) 478-1025
(909) 478-1476
Mailing address
11175 MOUNTAIN VIEW AVE, SUITE K, LOMA LINDA, CA 92354-3865
(909) 478-1025
(909) 478-1476
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
MMM00317M
CA
Other
Enumeration date
03/15/2007
Last updated
06/26/2008
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