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General NPI Number Information
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NPI Number | 1982386553
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Entity Type | Organization
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Legal Business Name | PHLEBMAX LABORATORY SERVICES
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Dates
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Enumeration Date | 08/03/2023
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | 5857 LORELEI AVE
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City | LAKEWOOD
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State | CA
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Zip | 90712-1302
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Country | US
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Telephone | 626-634-0072
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Fax |
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Provider Business Mailing Address
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Address Line | 5857 LORELEI AVE
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City | LAKEWOOD
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State | CA
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Zip | 90712-1302
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Country | US
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Telephone | 626-634-0072
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Fax |
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Authorized Official
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Title or Position | LEAD TECHNICIAN
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Name | MR. JOSE MARI MALPAS SANTOS
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Credential |
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Telephone | 626-634-0072
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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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