Organization
EL DORADO COUNTY PUBLIC HEALTH LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL DEATHERAGE (LABORATORY DIRECTOR)
(530) 621-6115
Entity
Organization
Contact information
Practice address
931 SPRING ST, PLACERVILLE, CA 95667-4543
(530) 621-6115
(530) 642-8531
Mailing address
931 SPRING ST, PLACERVILLE, CA 95667-4543
(530) 621-6115
(530) 642-8531
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB58853F
—
CA
Enumeration date
01/29/2007
Last updated
08/22/2020
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