Healthcare Provider Details

I. General information

NPI: 1528564002
Provider Name (Legal Business Name): UNITED LAB SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2018
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3811 BEDFORD CANYON RD. SUITE 104
CORONA CA
92883-4465
US

IV. Provider business mailing address

3811 BEDFORD CANYON RD. SUITE 104
CORONA CA
92883-4465
US

V. Phone/Fax

Practice location:
  • Phone: 951-444-0467
  • Fax: 951-582-4758
Mailing address:
  • Phone: 951-444-0467
  • Fax: 951-582-4758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: ANABELLE MYERS
Title or Position: CEO
Credential:
Phone: 951-444-0467