Organization
EL DORADO COUNTY PUBLIC HEALTH LABORATORY
Active
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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