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NPI Code Detail

MEDICARE: DUZ MOR DIAGNOSTIC LAB INC

MEDICARE: DUZ MOR DIAGNOSTIC LAB 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 LaboratoryCLF3216CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881699346
Entity Type Code : Organization
Provider Name (Legal Business Name) : DUZ MOR DIAGNOSTIC LAB INC
Provider Business Mailing Address
First Line : 2700 W MANCHESTER BLVD
Second Line :
City : INGLEWOOD
State : CA
Zip : 90305-2436
Country : US
Telephone Number : 323-758-5161
Fax Number :
Provider Business Practice Location Address
First Line : 2700 W MANCHESTER BLVD
Second Line :
City : INGLEWOOD
State : CA
Zip : 90305-2436
Country : US
Telephone Number : 323-758-5161
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. JOE L MOREHEAD
Credential :
Telephone Number : 323-971-0635
Provider Enumeration Date : 06/20/2005
Last Update Date : 08/22/2020

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