Organization
APPLIED PATHOLOGY MEDICAL ASSOCIATES
Active
Organization
APPLIED PATHOLOGY MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM R STARKE MD (OWNER DIRECTOR)
(760) 347-8947
Entity
Organization
Contact information
Practice address
81-715 DR CARREON BLVD, STE A2, INDIO, CA 92201-5526
(760) 347-8947
(760) 347-2542
Mailing address
81-715 DR CARREON BLVD, STE A2, INDIO, CA 92201-5526
(760) 347-8947
(760) 347-2542
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF4029
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0643136
CLIA
CA
01
—
CLF4029
LAB ID
CA
05
—
LAB43136F
—
CA
Enumeration date
03/01/2006
Last updated
06/12/2008
Update your record
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