Organization
COUNTY OF MERCED
Active
Other names
Merced County Lab
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH HAVENS (FISCAL MANAGER)
(209) 381-1200
Entity
Organization
Contact information
Practice address
260 E 15TH ST, MERCED, CA 95340-6216
(209) 381-1200
(209) 381-1215
Mailing address
260 E 15TH ST, MERCED, CA 95340-6216
(209) 381-1200
(209) 381-1215
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB00866F
—
CA
Enumeration date
06/04/2007
Last updated
10/07/2010
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