Provider Demographics
NPI:1700212735
Name:EXCELTOX LABORATORIES, LLC.
Entity Type:Organization
Organization Name:EXCELTOX LABORATORIES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-343-1916
Mailing Address - Street 1:6789 QUAIL HILL PKWY
Mailing Address - Street 2:SUITE 224
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92603-4233
Mailing Address - Country:US
Mailing Address - Phone:877-202-7019
Mailing Address - Fax:949-423-3100
Practice Address - Street 1:15375 BARRANCA PKWY STE E104
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618
Practice Address - Country:US
Practice Address - Phone:877-202-7019
Practice Address - Fax:949-423-3100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-23
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory