Provider Demographics
NPI:1386850352
Name:COUNTY OF TULARE HEALTH AND HUMAN SERVICES
Entity Type:Organization
Organization Name:COUNTY OF TULARE HEALTH AND HUMAN SERVICES
Other - Org Name:TULARE COUNTY CLINICAL LABORATORY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF HEALTH SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:BULLICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-737-4669
Mailing Address - Street 1:5957 S MOONEY BLVD
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-9394
Mailing Address - Country:US
Mailing Address - Phone:559-737-4669
Mailing Address - Fax:559-737-4697
Practice Address - Street 1:1062 S K ST
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-6421
Practice Address - Country:US
Practice Address - Phone:559-685-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALAB43465FMedicaid