Provider Demographics
NPI:1093305922
Name:CLEAR ANALYTICS LABORATORY LLC
Entity Type:Organization
Organization Name:CLEAR ANALYTICS LABORATORY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-913-5747
Mailing Address - Street 1:18003 SKY PARK CIR STE B&C
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-6513
Mailing Address - Country:US
Mailing Address - Phone:407-913-5747
Mailing Address - Fax:
Practice Address - Street 1:18003 SKY PARK CIR STE B&C
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6513
Practice Address - Country:US
Practice Address - Phone:407-913-5747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory