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General NPI Number Information
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NPI Number | 1932200888
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Entity Type | Organization
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Legal Business Name | COLWELL CLINICAL LABORATORIES INC
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 04/30/2008
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Provider Practice Location Address
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Address Line | 1125 E 17TH STREET SUITE N156
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City | SANTA ANA
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State | CA
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Zip | 92701
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Country | US
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Telephone | 714-834-1872
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Fax | 714-834-1141
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Provider Business Mailing Address
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Address Line | 1125 E 17TH ST SUITE N156
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City | SANTA ANA
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State | CA
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Zip | 92701-2201
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Country | US
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Telephone | 714-834-1872
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Fax | 714-834-1141
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Authorized Official
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Title or Position | PRESIDENT
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Name | NEIL O COLWELL
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Credential |
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Telephone | 714-834-1872
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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 | CLF4478
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License Number State | CA
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