MEDICARE: CORDELL LABS LLC DBA SPECIALTY LABORATORIES

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
1	246QL0900X	Laboratory Management Specialist/Technologist

General Provider Information

NPI Number	:	1801738364
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORDELL LABS LLC DBA SPECIALTY LABORATORIES

Provider Business Mailing Address
First Line	:	1935 CORDELL CT STE 200
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92020-0911
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1935 CORDELL CT STE 200
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92020-0911
Country	:	US
Telephone Number	:	619-708-3999
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DAVID BARKA
Credential	:
Telephone Number	:	619-708-3999

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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