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General NPI Number Information
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NPI Number | 1942531926
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Entity Type | Organization
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Legal Business Name | OC CLINICAL LABORATORY INC
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Dates
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Enumeration Date | 01/15/2010
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Last Update Date | 05/06/2011
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Provider Practice Location Address
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Address Line | 2301 W LINCOLN AVE STE 220
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City | ANAHEIM
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State | CA
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Zip | 92801-5135
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Country | US
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Telephone | 714-635-0100
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Fax | 714-635-4300
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Provider Business Mailing Address
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Address Line | 2301 WEST LINCOLN AVE SUITE # 220
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City | ANAHEIM
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State | CA
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Zip | 92801-5135
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Country | US
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Telephone | 714-635-0100
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Fax | 714-635-4300
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. AVETIS AMALYAN
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Credential |
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Telephone | 714-635-0100
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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 | 339261
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | CLF339261
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License Number State | CA
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