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General NPI Number Information
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NPI Number | 1811457922
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Entity Type | Organization
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Legal Business Name | GENLAB INC
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Dates
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Enumeration Date | 03/24/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 1615 SWEETWATER RD
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City | NATIONAL CITY
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State | CA
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Zip | 91950-7655
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Country | US
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Telephone | 725-777-8066
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Fax |
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Provider Business Mailing Address
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Address Line | 2950 S RAINBOW BLVD STE 260
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City | LAS VEGAS
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State | NV
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Zip | 89146-6213
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Country | US
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Telephone | 702-233-8601
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Fax | 702-233-8608
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Authorized Official
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Title or Position | CEO
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Name | ALEJANDRO PABRIAGA
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Credential |
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Telephone | 702-233-8601
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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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