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General NPI Number Information
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NPI Number | 1568555134
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Entity Type | Organization
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Legal Business Name | AMERICAN CLINICAL REFERENCE LABORATORY INC.
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 12/01/2017
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Provider Practice Location Address
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Address Line | 701 BREA CANYON RD SUITE 11
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City | WALNUT
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State | CA
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Zip | 91789-3036
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Country | US
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Telephone | 909-444-0707
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Fax | 909-444-0710
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Provider Business Mailing Address
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Address Line | 701 BREA CANYON RD SUITE 11
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City | WALNUT
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State | CA
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Zip | 91789-3036
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Country | US
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Telephone | 909-444-0707
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Fax | 909-444-0710
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Authorized Official
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Title or Position | CEO / OWNER
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Name | MR. ARTOUR ATOIAN
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Credential |
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Telephone | 909-444-0707
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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 | CLF11197
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License Number State | CA
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