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General NPI Number Information
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NPI Number | 1659655124
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Entity Type | Organization
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Legal Business Name | CAP DIAGNOSTICS LLC
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Dates
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Enumeration Date | 10/03/2011
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Last Update Date | 12/21/2022
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Provider Practice Location Address
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Address Line | 15545 SAND CANYON AVE STE 100&200
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City | IRVINE
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State | CA
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Zip | 92618-3114
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Country | US
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Telephone | 714-966-1221
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Fax | 714-966-1231
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Provider Business Mailing Address
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Address Line | 15545 SAND CANYON AVE STE 100&200
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City | IRVINE
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State | CA
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Zip | 92618-3114
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Country | US
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Telephone | 714-966-1221
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Fax | 714-966-1231
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Authorized Official
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Title or Position | COMPLIANCE
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Name | PAMELA DELBRIDGE
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Credential |
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Telephone | 714-966-1221
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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 | 05D2024468
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License Number State | CA
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