| NPI | 1508157520 |
|---|---|
| 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 |