Clinical Laboratory Information
Similar CLIA Codes
|
|
CLIA Number
|
05D0698619
|
|
Clinical laboratory number
|
|
Lab Name
|
BRUCE BLACKHART MD
|
|
Laboratory Name
|
|
Lab Type
|
Physician Office
|
|
Laboratory Type
|
|
Certificate Type
|
PPMP
|
|
Clinical laboratory certificate type
|
Contacts |
|
Phone
|
209-848-1005
|
|
Laboratory telephone number
|
|
Fax
|
209-845-8918
|
|
Fax number of the provider.
|
Facility Location |
|
Street Address
|
1425 WEST H ST, SUITE 200
|
|
Primary location adress line
|
|
City
|
OAKDALE
|
|
Primary location city name
|
|
State
|
CA
|
|
Primary location state name
|
|
Zip
|
95361
|
|
Primary location postal code
|