Provider Demographics
NPI:1578220026
Name:GL CA CLIA LLC
Entity Type:Organization
Organization Name:GL CA CLIA LLC
Other - Org Name:MY CARE LABS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HERJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-790-4550
Mailing Address - Street 1:5500 STEWART AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-3100
Mailing Address - Country:US
Mailing Address - Phone:510-203-6087
Mailing Address - Fax:
Practice Address - Street 1:5500 STEWART AVE STE 108
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-3100
Practice Address - Country:US
Practice Address - Phone:510-203-6087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-19
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical LaboratoryGroup - Single Specialty