Provider Demographics
NPI:1619700895
Name:NORTH VALLEY LABORATORY
Entity type:Organization
Organization Name:NORTH VALLEY LABORATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HELDAI
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUILAR
Authorized Official - Suffix:
Authorized Official - Credentials:CPT1
Authorized Official - Phone:530-649-7945
Mailing Address - Street 1:1000 LINCOLIN RD STE H
Mailing Address - Street 2:PMB 813
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95953
Mailing Address - Country:US
Mailing Address - Phone:530-649-7945
Mailing Address - Fax:
Practice Address - Street 1:1000 LINCOLIN RD STE H
Practice Address - Street 2:PMB 813
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95953
Practice Address - Country:US
Practice Address - Phone:530-649-7945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty