| Organization Name: | WOOLDRIDGE TISSUE SERVICE, INC |
| NPI Number: | 1013974385 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JUNE ADAMS (MEDICAL BILLING REP) |
| Mailing Address: | 15319 S Avalon Blvd Gardena |
| State: | CA US |
| Postal Code: | 902482304 |
| Phone Number: | 2095754575 |
| Fax Number: | 2095754598 |
| NPI Enumeration Date: | 04/28/2006 |
| NPI Last Update Date: | 02/07/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246QH0600X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Spec/Tech, Pathology |
| Taxonomy Specialization: | Histology |
| Taxonomy Definition: | |