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General NPI Number Information
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NPI Number | 1326907924
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Entity Type | Organization
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Legal Business Name | MILLER LAB SERVICES
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Dates
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Enumeration Date | 01/19/2026
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Last Update Date | 01/19/2026
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Provider Practice Location Address
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Address Line | 306 E MAIN ST STE 202
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City | STOCKTON
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State | CA
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Zip | 95202-2908
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Country | US
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Telephone | 209-616-8409
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Fax | 209-266-3694
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Provider Business Mailing Address
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Address Line | 306 E MAIN ST STE 202
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City | STOCKTON
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State | CA
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Zip | 95202-2908
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Country | US
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Telephone | 209-616-8409
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Fax | 209-266-3694
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Authorized Official
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Title or Position | OWNER
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Name | TIFFANY JIMENEZ
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Credential | DO
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Telephone | 209-616-8409
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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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