Lee Histology Lab

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

LEE HISTOLOGY LAB

Practice address

1212 Farmers LN
4
Santa Rosa, CA 95405-6747

Phone

(707) 528-0166

Fax

(707) 591-9351

NPI assigned

Mar 13, 2007

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Thomas Michael Lee, HT

Title

Lab Owner

Phone

(707) 528-0166

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1730212218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 FARMERS LN",
            "address_2": "4",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954056747",
            "telephone_number": "707-528-0166",
            "fax_number": "707-591-9351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 FARMERS LN",
            "address_2": "4",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954056747",
            "telephone_number": "707-528-0166",
            "fax_number": "707-591-9351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE HISTOLOGY LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "LAB OWNER",
        "authorized_official_telephone_number": "707-528-0166",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "HT"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Jeanne Lecount
• Bradly S Ledbetter
• Richard Barry Lederman, MD
• Natividad Ledoux, LVN
• Titilia Ledua
• Jane H Lee-Koida, O.D.
• Amanda Michelle Lee
• Amanda Zhou Lee, L.AC
• Amy K Lee, R.N., L.AC
• CHI-Chan Lee, M.D

• Clinical Medical Laboratory in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.