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Organization

MICROCORRE DIAGNOSTIC LABORATORY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GARY A WALTER M.D. (DIRECTOR OWNER)
(559) 686-4000
Entity
Organization

Contact information

Practice address
890 N CHERRY ST, TULARE, CA 93274-2208
(559) 686-4000
(559) 686-9432
Mailing address
890 N CHERRY ST, TULARE, CA 93274-2208
(559) 686-4000
(559) 686-9432

Taxonomy

Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
CLF1717
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ZZZ58691Z
CA
Enumeration date
07/21/2006
Last updated
12/04/2007
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