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General NPI Number Information
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NPI Number | 1902403926
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Entity Type | Organization
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Legal Business Name | INNERHEALTH LABORATORY, INC
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Dates
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Enumeration Date | 10/02/2020
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Last Update Date | 10/02/2020
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Provider Practice Location Address
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Address Line | 30151B AVENIDA DE LAS BANDERA STE 100
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City | RANCHO SANTA MARGARITA
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State | CA
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Zip | 92688-2114
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Country | US
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Telephone | 949-463-3331
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Fax |
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Provider Business Mailing Address
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Address Line | 30151B AVENIDA DE LAS BANDERA STE 100
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City | RANCHO SANTA MARGARITA
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State | CA
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Zip | 92688-2114
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Country | US
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Telephone | 949-463-3331
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MICHAEL M FINI
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Credential | CLS, MT(ASCP)
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Telephone | 949-463-3331
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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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