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?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05D1015742OtherCLIA