Provider First Line Business Practice Location Address:
215 W JANSS RD
Provider Second Line Business Practice Location Address:
PATHOLOGY DEPT
Provider Business Practice Location Address City Name:
THOUSAND OAKS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91360
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-373-8582
Provider Business Practice Location Address Fax Number:
805-373-6865
Provider Enumeration Date:
02/28/2006