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General NPI Number Information
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NPI Number | 1467030536
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Entity Type | Organization
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Legal Business Name | WORKSITE LABS, INC.
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Dates
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Enumeration Date | 03/31/2021
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Last Update Date | 06/14/2024
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Provider Practice Location Address
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Address Line | 1890 E MIRALOMA AVE STE D
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City | PLACENTIA
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State | CA
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Zip | 92870-6746
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Country | US
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Telephone | 833-747-1122
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Fax |
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Provider Business Mailing Address
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Address Line | 65 PINE AVE STE 370
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City | LONG BEACH
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State | CA
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Zip | 90802-4718
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Country | US
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Telephone | 661-599-9150
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. GARY FRAZIER
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Credential |
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Telephone | 661-599-9150
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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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