Provider Demographics
NPI:1831494178
Name:REDWOOD LABORATORY MANAGEMENT
Entity Type:Organization
Organization Name:REDWOOD LABORATORY MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P. OF ACCOUNT SERVICE
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:GLOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-931-6912
Mailing Address - Street 1:22568 MISSION BLVD # 414
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-5116
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1558 B ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-3052
Practice Address - Country:US
Practice Address - Phone:510-856-4390
Practice Address - Fax:800-681-2650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory