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General NPI Number Information
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NPI Number | 1265514210
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Entity Type | Organization
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Legal Business Name | COUNTY OF FRESNO
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 05/16/2014
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Provider Practice Location Address
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Address Line | 1221 FULTON MALL PUBLIC HEALTH LAB, BASEMENT
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City | FRESNO
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State | CA
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Zip | 93721-1915
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Country | US
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Telephone | 559-600-3200
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Fax | 559-600-7687
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Provider Business Mailing Address
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Address Line | PO BOX 11867 PUBLIC HEALTH LAB, BASEMENT
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City | FRESNO
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State | CA
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Zip | 93775-1867
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Country | US
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Telephone | 559-600-3200
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Fax | 559-600-7687
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. DAVID POMAVILLE
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Credential | M.B.A., R.E.H.S.
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Telephone | 559-600-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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