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General NPI Number Information
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NPI Number | 1972967933
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Entity Type | Organization
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Legal Business Name | FOUR TECH LABORATORY LLC
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Dates
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Enumeration Date | 04/06/2016
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Last Update Date | 11/07/2022
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Provider Practice Location Address
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Address Line | 5132 PECK RD
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City | EL MONTE
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State | CA
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Zip | 91732-1426
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Country | US
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Telephone | 626-401-2583
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Fax | 626-401-2618
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Provider Business Mailing Address
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Address Line | 5132 PECK RD
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City | EL MONTE
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State | CA
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Zip | 91732-1426
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Country | US
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Telephone | 626-401-2583
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Fax | 626-401-2618
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Authorized Official
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Title or Position | OWNER
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Name | MRS. VICTORIA ABRIGO
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Credential |
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Telephone | 626-401-2583
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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 | CLF 349083
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License Number State | CA
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