=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790985661
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AVIIR, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/19/2007
-----------------------------------------------------
Last Update Date | 10/26/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9805 RESEARCH DR
-----------------------------------------------------
City | IRVINE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92618-4304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-398-6300
-----------------------------------------------------
Fax | 949-398-6303
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9805 RESEARCH DR
-----------------------------------------------------
City | IRVINE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92618-4304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-398-6300
-----------------------------------------------------
Fax | 949-398-6303
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF EXECUTIVE OFFICER
-----------------------------------------------------
Name | DR. DOUGLAS HARRINGTON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 949-398-6300
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 291U00000X
-----------------------------------------------------
Taxonomy Name | Clinical Medical Laboratory
-----------------------------------------------------
License Number | PENDING
-----------------------------------------------------
License Number State |
-----------------------------------------------------