Healthcare Provider Details

I. General information

NPI: 1245145358
Provider Name (Legal Business Name): CHRISTINA MARSHALL LAB TECH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2615 E CLINTON AVE
FRESNO CA
93703-2223
US

IV. Provider business mailing address

44901 DOUGLAS RD S
COARSEGOLD CA
93614-9005
US

V. Phone/Fax

Practice location:
  • Phone: 559-225-6100
  • Fax:
Mailing address:
  • Phone: 559-273-3911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246QM0706X
TaxonomyMedical Technologist
License Number00038753
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: