Provider Demographics
NPI:1568042489
Name:ATLAS QUALITY ASSURANCE LABORATORIES, LLC
Entity Type:Organization
Organization Name:ATLAS QUALITY ASSURANCE LABORATORIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:BARNARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-559-2614
Mailing Address - Street 1:3563 OLD CONEJO RD
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-2122
Mailing Address - Country:US
Mailing Address - Phone:805-375-3939
Mailing Address - Fax:
Practice Address - Street 1:3563 OLD CONEJO RD
Practice Address - Street 2:
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-2122
Practice Address - Country:US
Practice Address - Phone:805-375-3939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-13
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory