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General NPI Number Information
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NPI Number | 1790352706
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Entity Type | Organization
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Legal Business Name | JP EXPRESS LABORATORY, INC
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Dates
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Enumeration Date | 06/08/2021
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Last Update Date | 10/05/2022
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Provider Practice Location Address
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Address Line | 935 S MOUNT VERNON AVE STE 109
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City | COLTON
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State | CA
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Zip | 92324-3963
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Country | US
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Telephone | 909-645-8200
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Fax | 909-347-7059
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Provider Business Mailing Address
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Address Line | 935 S MOUNT VERNON AVE STE 109
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City | COLTON
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State | CA
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Zip | 92324-3963
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Country | US
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Telephone | 909-645-8200
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Fax | 909-347-7059
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Authorized Official
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Title or Position | CEO
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Name | MRS. AILEEN LUNA
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Credential |
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Telephone | 626-475-5923
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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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