Provider Demographics
NPI:1548771736
Name:USA BIOSCIENCES LLC
Entity Type:Organization
Organization Name:USA BIOSCIENCES LLC
Other - Org Name:INLAND EMPIRE LABORATORIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:BASA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-755-7530
Mailing Address - Street 1:20695 S WESTERN AVE STE 112
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-1834
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20695 S WESTERN AVE STE 112
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-1834
Practice Address - Country:US
Practice Address - Phone:310-755-7530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-16
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00351857OtherCLINICAL LICENSE