Organization
PREMIER PATHOLOGY LABORATORIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA HANKS MD (PRESIDENT)
(559) 781-5174
Entity
Organization
Contact information
Practice address
465 W PUTNAM AVE, PORTERVILLE, CA 93257-3320
(559) 781-5174
Mailing address
PO BOX 10076, VAN NUYS, CA 91410-0076
(805) 578-8300
(805) 578-8950
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB85481F
—
CA
Enumeration date
04/20/2006
Last updated
08/22/2020
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