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General NPI Number Information
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NPI Number | 1497773444
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Entity Type | Organization
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Legal Business Name | UNILAB CORPORATION
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 04/28/2011
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Provider Practice Location Address
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Address Line | 4204 RIVERWALK PARKWAY SUITE 340
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City | RIVERSIDE
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State | CA
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Zip | 92505-3391
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Country | US
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Telephone | 951-602-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 ADAMS AVE MRGOV 2ND FLOOR
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City | NORRISTOWN
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State | PA
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Zip | 19403-2429
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Country | US
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Telephone | 484-676-7705
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Fax | 484-676-5309
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Authorized Official
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Title or Position | VP OF REVENUE SERVICES
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Name | GERALD SCOTT CARTIER
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Credential |
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Telephone | 484-676-7731
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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 | 05D0703624
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License Number State | CA
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