Provider Demographics
NPI:1528165883
Name:COUNTY OF SANTA CLARA
Entity type:Organization
Organization Name:COUNTY OF SANTA CLARA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LABORATORY DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:DADONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-885-4272
Mailing Address - Street 1:2220 MOORPARK AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2613
Mailing Address - Country:US
Mailing Address - Phone:408-885-4272
Mailing Address - Fax:408-885-4275
Practice Address - Street 1:2220 MOORPARK AVE FL 2
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2613
Practice Address - Country:US
Practice Address - Phone:408-885-4272
Practice Address - Fax:408-885-4275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPH1281291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACPH1281OtherSTATE LICENSE NUMBER
CAZZZ59166ZOtherMEDI-CAL NUMBER