NPI | 1508157520 |
---|---|
Doing Business As | LIFESTREAM |
Entity Type | Organization |
Authorized Contact | FREDERICK B AXELROD President/CEO/Medical Director 909-885-6503 |
Organization Subpart ? | No |
Primary Taxonomy | 331L00000X Blood Bank (Licence: CA 9021) |
Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: CA CLF3556) |
Enumeration Date | 2011-04-25 |
Last Update Date | 2011-04-25 |