Healthcare Provider Details

I. General information

NPI: 1245255165
Provider Name (Legal Business Name): TURNER PARASITOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 12/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 W CARSON ST SUITE 104
CARSON CA
90745-2642
US

IV. Provider business mailing address

519 W CARSON ST SUITE 104
CARSON CA
90745-2642
US

V. Phone/Fax

Practice location:
  • Phone: 310-212-6559
  • Fax: 310-212-7367
Mailing address:
  • Phone: 310-212-6559
  • Fax: 310-212-7367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License NumberCLF4223
License Number StateCA

VIII. Authorized Official

Name: MARILYN J CARROLL
Title or Position: LABORATORY MANAGER OWNER
Credential: MT ASCP
Phone: 310-212-6559