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General NPI Number Information
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NPI Number | 1558755496
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Entity Type | Organization
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Legal Business Name | NEXTGEN LABORATORIES, INC.
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Dates
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Enumeration Date | 03/27/2015
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Last Update Date | 09/28/2023
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Provider Practice Location Address
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Address Line | 4229 BIRCH ST SUITE 130
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-1902
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Country | US
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Telephone | 949-467-9770
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Fax | 949-272-3252
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Provider Business Mailing Address
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Address Line | 4229 BIRCH ST SUITE 130
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-1902
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Country | US
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Telephone | 949-467-9770
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Fax | 949-272-3252
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Authorized Official
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Title or Position | CEO
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Name | JOSEPH DEL SIGNORE
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Credential |
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Telephone | 949-467-9770
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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 | CLF00011097
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License Number State | CA
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