Provider Demographics
NPI:1821457540
Name:TRUE NORTH LAB, LLC
Entity Type:Organization
Organization Name:TRUE NORTH LAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & COO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-650-4334
Mailing Address - Street 1:4343 VON KARMAN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2098
Mailing Address - Country:US
Mailing Address - Phone:949-269-9207
Mailing Address - Fax:949-269-9258
Practice Address - Street 1:2183 FAIRVIEW RD STE 100
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-5671
Practice Address - Country:US
Practice Address - Phone:949-269-9207
Practice Address - Fax:949-269-9258
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL THERAPEUTIC SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-23
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA05D2088507291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory