Provider Demographics
NPI:1982944260
Name:ARIZONA TOXICOLOGY MANAGEMENT, LLC
Entity Type:Organization
Organization Name:ARIZONA TOXICOLOGY MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-648-1174
Mailing Address - Street 1:1464 MADERA RD # N-182
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-3077
Mailing Address - Country:US
Mailing Address - Phone:805-416-1678
Mailing Address - Fax:805-823-6519
Practice Address - Street 1:980 ENCHANTED WAY STE 211
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-0914
Practice Address - Country:US
Practice Address - Phone:805-416-1648
Practice Address - Fax:805-823-6519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory