Healthcare Provider Details

I. General information

NPI: 1982531992
Provider Name (Legal Business Name): SUMMIT CLINICAL LABORATORY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 N BROOKHURST ST STE 120
ANAHEIM CA
92801-5620
US

IV. Provider business mailing address

431 N BROOKHURST ST STE 120
ANAHEIM CA
92801-5620
US

V. Phone/Fax

Practice location:
  • Phone: 626-364-9907
  • Fax:
Mailing address:
  • Phone: 626-364-9907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: NGOC PHUOC HO
Title or Position: CEO
Credential:
Phone: 626-364-9907