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General NPI Number Information
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NPI Number | 1164259214
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Entity Type | Organization
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Legal Business Name | PACIFIC TOXICOLOGY LABORATORIES
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Dates
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Enumeration Date | 09/13/2024
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 231 CAPITOL ST STE 7
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City | CHARLESTON
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State | WV
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Zip | 25301-2200
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Country | US
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Telephone | 818-598-3110
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Fax | 818-598-3116
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Provider Business Mailing Address
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Address Line | PO BOX 10076
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City | VAN NUYS
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State | CA
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Zip | 91410-0076
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Country | US
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Telephone | 805-578-8300
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Fax | 805-578-3911
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Authorized Official
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Title or Position | CFO
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Name | MARIE HAKIM
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Credential |
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Telephone | 818-678-4460
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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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