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General NPI Number Information
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NPI Number | 1730570987
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Entity Type | Organization
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Legal Business Name | US LAB, INC
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Dates
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Enumeration Date | 02/10/2015
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Last Update Date | 09/19/2017
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Provider Practice Location Address
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Address Line | 3194 AIRPORT LOOP DR STE. A
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City | COSTA MESA
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State | CA
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Zip | 92626-3405
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Country | US
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Telephone | 888-787-8210
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Fax | 714-399-3674
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Provider Business Mailing Address
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Address Line | 3194 AIRPORT LOOP DR STE A
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City | COSTA MESA
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State | CA
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Zip | 92626-3405
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Country | US
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Telephone | 888-787-8210
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Fax | 714-399-3674
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Authorized Official
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Title or Position | CEO
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Name | MR. MATTHEW LEE UMBS
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Credential |
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Telephone | 949-777-3334
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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 | DRH65
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License Number State | CA
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