Provider First Line Business Practice Location Address:
1080 EMELINE AVE
Provider Second Line Business Practice Location Address:
LABORATORY
Provider Business Practice Location Address City Name:
SANTA CRUZ
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-454-5445
Provider Business Practice Location Address Fax Number:
831-454-5000
Provider Enumeration Date:
02/06/2007