Provider Demographics
NPI:1659779643
Name:ELEMENT 7 LABS LLC
Entity Type:Organization
Organization Name:ELEMENT 7 LABS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUNOCH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:714-966-1221
Mailing Address - Street 1:3189 AIRWAY AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-4612
Mailing Address - Country:US
Mailing Address - Phone:949-370-3509
Mailing Address - Fax:714-966-1231
Practice Address - Street 1:3189 AIRWAY AVE
Practice Address - Street 2:SUITE D
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4612
Practice Address - Country:US
Practice Address - Phone:949-370-3509
Practice Address - Fax:714-966-1231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-08
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory