Provider Demographics
NPI:1891116430
Name:FAMILY PHYSICIANS LABORATORIES,INC.
Entity Type:Organization
Organization Name:FAMILY PHYSICIANS LABORATORIES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLS
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOLITA
Authorized Official - Middle Name:IGNACIO
Authorized Official - Last Name:ESNAOLA
Authorized Official - Suffix:
Authorized Official - Credentials:CLS
Authorized Official - Phone:559-355-1602
Mailing Address - Street 1:1163 E WOODHAVEN LN
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-1414
Mailing Address - Country:US
Mailing Address - Phone:559-355-1602
Mailing Address - Fax:
Practice Address - Street 1:3121 E OLIVE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93702-1030
Practice Address - Country:US
Practice Address - Phone:559-355-1602
Practice Address - Fax:559-277-2723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-28
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMTA35029291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory