Provider Demographics
NPI:1639642564
Name:FOUNDATION LABS LLC
Entity type:Organization
Organization Name:FOUNDATION LABS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ANOOPJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:LOHARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-353-5907
Mailing Address - Street 1:PO BOX 3387
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-2387
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:701 E 28TH ST STE 116
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2771
Practice Address - Country:US
Practice Address - Phone:562-206-0744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TPIRC MEDICAL FOUNDATION INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-03
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory