| NPI | 1023253556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAUSTO MENDEZ Managing Member 626-303-8674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: CA CLF1817) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: CA 05D0642547) |
| Enumeration Date | 2008-12-12 |
| Last Update Date | 2013-10-08 |