Healthcare Provider Details

I. General information

NPI: 1144731605
Provider Name (Legal Business Name): CURATIVE LABS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2017
Last Update Date: 10/14/2022
Certification Date: 10/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 S CATARACT AVE
SAN DIMAS CA
91773-2902
US

IV. Provider business mailing address

430 S CATARACT AVE
SAN DIMAS CA
91773-2902
US

V. Phone/Fax

Practice location:
  • Phone: 424-645-7575
  • Fax: 424-644-2575
Mailing address:
  • Phone: 888-702-9042
  • Fax: 833-520-5353

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: TAMI CIRANNA
Title or Position: CFO
Credential:
Phone: 626-524-6077