Provider Demographics
NPI:1568698512
Name:CALIFORNIA MOLECULAR REFERENCE LABORATORIES
Entity Type:Organization
Organization Name:CALIFORNIA MOLECULAR REFERENCE LABORATORIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:HIROSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:949-487-5100
Mailing Address - Street 1:24407 CALLE DE LA LOUISA STE 100
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3650
Mailing Address - Country:US
Mailing Address - Phone:949-581-0555
Mailing Address - Fax:949-581-7555
Practice Address - Street 1:24407 CALLE DE LA LOUISA STE 100
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3650
Practice Address - Country:US
Practice Address - Phone:949-581-0555
Practice Address - Fax:949-581-7555
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THOMAS G. HIROSE M.D. A PROFESSIONAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-04
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory