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NPI Code Detail

MEDICARE: PACIFIC POINT LABORATORIES, INC.

MEDICARE: PACIFIC POINT LABORATORIES, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1457341851
Entity Type Code : Organization
Provider Name (Legal Business Name) : PACIFIC POINT LABORATORIES, INC.
Provider Business Mailing Address
First Line : 3701 S HIGUERA ST STE 200
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-7462
Country : US
Telephone Number : 805-541-6033
Fax Number : 805-541-6116
Provider Business Practice Location Address
First Line : 3701 S HIGUERA ST STE 200
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-7462
Country : US
Telephone Number : 805-541-6033
Fax Number : 805-541-6916
Authorized Official
Title or Position : PRESIDENT
Name : CORY A ROBERTS
Credential : MD, MBA
Telephone Number : 214-237-1641
Provider Enumeration Date : 10/26/2005
Last Update Date : 04/18/2024

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Directions to “PACIFIC POINT LABORATORIES, INC. ” Practice Location

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