Provider Demographics
NPI:1669795860
Name:NATIONAL TOXICOLOGY LABORATORIES, INC.
Entity type:Organization
Organization Name:NATIONAL TOXICOLOGY LABORATORIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:SNEATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-322-4250
Mailing Address - Street 1:1100 CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304-1402
Mailing Address - Country:US
Mailing Address - Phone:661-322-4250
Mailing Address - Fax:661-322-4322
Practice Address - Street 1:1100 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-1402
Practice Address - Country:US
Practice Address - Phone:661-322-4250
Practice Address - Fax:661-322-4322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-03
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05D0667354OtherCENTERS FOR MEDICARE & MEDICAID SERVICES - CLIA
CALAB04701FOtherMEDI-CAL