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General NPI Number Information
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NPI Number | 1851748008
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Entity Type | Organization
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Legal Business Name | TERRATOX LABORATORIES, INC.
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Dates
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Enumeration Date | 05/18/2016
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Last Update Date | 06/14/2018
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Provider Practice Location Address
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Address Line | 6510 WEST 91ST AVE SUITE 90
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City | WESTMINISTER
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State | CO
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Zip | 80031-2929
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Country | US
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Telephone | 949-244-1115
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Fax |
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Provider Business Mailing Address
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Address Line | 3419 VIA LIDO SUITE 668
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-3908
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | KEVIN MELLO
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Credential |
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Telephone | 949-244-1115
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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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