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General NPI Number Information
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NPI Number | 1538686597
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Entity Type | Organization
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Legal Business Name | GENENTOX LABORATORIES LLC
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Dates
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Enumeration Date | 08/29/2017
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 2001 E 1ST ST STE 109
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City | SANTA ANA
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State | CA
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Zip | 92705-4020
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Country | US
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Telephone | 833-668-2522
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Fax | 833-668-2329
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Provider Business Mailing Address
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Address Line | 2001 E 1ST ST STE 109
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City | SANTA ANA
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State | CA
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Zip | 92705-4020
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Country | US
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Telephone | 833-668-2522
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Fax | 833-668-2329
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Authorized Official
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Title or Position | OWNER
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Name | AMBREEN WILLIAMS
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Credential |
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Telephone | 951-532-8893
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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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