Organization
CENTRAL COAST CLINICAL LABORATORY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RONA GRIFFIN MTASCP (OWNER)
(805) 434-9080
Entity
Organization
Contact information
Practice address
350 POSADA LN, SUITE 100, TEMPLETON, CA 93465-4059
(805) 434-9080
(805) 434-9082
Mailing address
350 POSADA LN, SUITE 100, TEMPLETON, CA 93465-4059
(805) 434-9080
(805) 434-9082
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF11785
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D1012891
MEDICARE - OTHER
—
01
—
CLF11785
DHS CLINICAL LAB LICENSE
CA
Enumeration date
07/06/2006
Last updated
03/17/2010
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