| NPI | 1265877542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN CHATFIELD HISERODT Medical Director/ Direct Owner 714-743-5253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2013-05-01 |