Provider Demographics
NPI:1396402509
Name:ALLIED REFERENCE LABORATORY
Entity Type:Organization
Organization Name:ALLIED REFERENCE LABORATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-336-2938
Mailing Address - Street 1:1971 ESSEX CT
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-8057
Mailing Address - Country:US
Mailing Address - Phone:888-577-7275
Mailing Address - Fax:909-363-8468
Practice Address - Street 1:1971 ESSEX CT
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-8057
Practice Address - Country:US
Practice Address - Phone:888-577-7275
Practice Address - Fax:909-363-8468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory