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General NPI Number Information
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NPI Number | 1124752480
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Entity Type | Organization
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Legal Business Name | NEWPORT DIAGNOSTICS LABORATORY
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Dates
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Enumeration Date | 07/13/2022
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 18242 MCDURMOTT W STE C
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City | IRVINE
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State | CA
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Zip | 92614-4773
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Country | US
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Telephone | 949-309-1632
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Fax |
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Provider Business Mailing Address
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Address Line | 18242 MCDURMOTT W STE C
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City | IRVINE
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State | CA
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Zip | 92614-4773
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Country | US
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Telephone | 949-385-3535
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Fax | 949-528-1313
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MR. JOSEPH HINSHAW
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Credential |
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Telephone | 949-468-8447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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