Healthcare Provider Details

I. General information

NPI: 1366577025
Provider Name (Legal Business Name): KINGS COUNTY PUBLIC HEALTH LABORATORY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 03/25/2022
Certification Date: 03/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 CAMPUS DR
HANFORD CA
93230-4375
US

IV. Provider business mailing address

330 CAMPUS DR
HANFORD CA
93230-4375
US

V. Phone/Fax

Practice location:
  • Phone: 559-584-1401
  • Fax: 559-583-8178
Mailing address:
  • Phone: 559-584-1401
  • Fax: 559-583-8178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number05D0643454
License Number StateCA

VIII. Authorized Official

Name: MARIA L ALVAREZ
Title or Position: MEDICAL BILLER 1
Credential:
Phone: 559-852-4517