| NPI | 1558329813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN LOUIS DAGOSTINO President 951-789-4356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: CA 05D1030088) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: CA CLR332061) |
| 331L00000X Blood Bank (Licence: CA sr eh 52034861) | |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: CA SR EH 52-034861) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2014-02-05 |