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General NPI Number Information
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NPI Number | 1871877977
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Entity Type | Organization
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Legal Business Name | UNITED CLINICAL LABORATORY INC
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Dates
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Enumeration Date | 10/06/2011
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Last Update Date | 10/06/2011
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Provider Practice Location Address
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Address Line | 2168 S ATLANTIC BLVD SUITE 475
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City | MONTEREY PARK
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State | CA
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Zip | 91754-6839
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Country | US
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Telephone | 562-450-9756
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Fax | 909-803-9790
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Provider Business Mailing Address
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Address Line | 2168 S ATLANTIC BLVD SUITE 475
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City | MONTEREY PARK
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State | CA
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Zip | 91754-6839
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Country | US
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Telephone | 562-450-9756
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Fax | 909-803-9790
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Authorized Official
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Title or Position | CEO / PRESIDENT
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Name | MR. CONRAD ROBERT FELIX
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Credential |
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Telephone | 562-450-9756
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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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