Provider Demographics
NPI: | 1598957631 |
---|---|
Name: | ACCUPATH DIAGNOSTIC LABORATORIES INC |
Entity Type: | Organization |
Organization Name: | ACCUPATH DIAGNOSTIC LABORATORIES INC |
Other - Org Name: | US LABS |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | VP |
Authorized Official - Prefix: | |
Authorized Official - First Name: | KIMBERLY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | WILLIAMS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 800-222-7566 |
Mailing Address - Street 1: | 2601 CAMPUS DR |
Mailing Address - Street 2: | |
Mailing Address - City: | IRVINE |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 92612-1601 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 888-875-2270 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 410 W FALLBROOK AVE |
Practice Address - Street 2: | SUITE 104 |
Practice Address - City: | FRESNO |
Practice Address - State: | CA |
Practice Address - Zip Code: | 93711-6197 |
Practice Address - Country: | US |
Practice Address - Phone: | 559-432-5472 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-08-13 |
Last Update Date: | 2013-12-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 291U00000X | Laboratories | Clinical Medical Laboratory |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CA | 05D1015742 | Other | CLIA |