Provider Demographics
NPI:1033845144
Name:CLEARNOTE HEALTH INC
Entity Type:Organization
Organization Name:CLEARNOTE HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF COMMERCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:833-258-7827
Mailing Address - Street 1:10578 SCIENCE CENTER DR STE 210
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1144
Mailing Address - Country:US
Mailing Address - Phone:833-258-7827
Mailing Address - Fax:
Practice Address - Street 1:10578 SCIENCE CENTER DR STE 210
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1144
Practice Address - Country:US
Practice Address - Phone:833-258-7827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-29
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05D2249973OtherCLIA LICENSE