Provider Demographics
NPI:1407165012
Name:UNITED CLINICAL LABORATORY, INC
Entity Type:Organization
Organization Name:UNITED CLINICAL LABORATORY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FIGUEROA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-326-3208
Mailing Address - Street 1:11410 DOLAN AVE
Mailing Address - Street 2:UNIT 333
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-4978
Mailing Address - Country:US
Mailing Address - Phone:562-326-3208
Mailing Address - Fax:909-803-9790
Practice Address - Street 1:3973 E SONGBIRD LN
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85739-9508
Practice Address - Country:US
Practice Address - Phone:562-326-3208
Practice Address - Fax:909-803-9790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory