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General NPI Number Information
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NPI Number | 1982479846
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Entity Type | Organization
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Legal Business Name | MEDLAB2020, INC
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Dates
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Enumeration Date | 11/21/2023
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Last Update Date | 11/21/2023
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Provider Practice Location Address
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Address Line | 567 D'ONOFRIO DRIVE SUITE 100
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City | MADISON
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State | WI
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Zip | 53719-2844
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Country | US
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Telephone | 714-947-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 300 SPECTRUM CENTER DRIVE SUITE 200
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City | IRVINE
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State | CA
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Zip | 92618-4987
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Country | US
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Telephone | 714-947-2020
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Fax |
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Authorized Official
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Title or Position | CEO, CFO, SECRETARY
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Name | MR. MATTHEW COLLINS
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Credential |
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Telephone | 949-791-7881
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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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