Organization
COUNTY OF STANISLAUS
Active
Other names
Stanislaus County Health Services Agency Public Health Lab
Organization subpart
No
Provider details
NPI number
Authorized official
MARYANN LEE (MANAGING DIRECTOR)
(209) 558-7163
Entity
Organization
Contact information
Practice address
820 SCENIC DR, MODESTO, CA 95350-6131
(209) 558-7700
(209) 558-8184
Mailing address
820 SCENIC DR, MODESTO, CA 95350-6131
(209) 558-7700
(209) 558-8184
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0668134
CLIA
CA
Enumeration date
03/09/2010
Last updated
03/09/2010
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