Mitomed Diagnostics Laboratory

LBN: Mitomed Diagnostics Laboratory
Mitomed Diagnostics Laboratory is an health care organization with primary practice located at 2501 Hewitt Hl University Of California Irvine, Irvine CA 92697-0001. The organization recently has only one registered license in Laboratories / Clinical Medical Laboratory, which is considered as the primary health care specialty. Mitomed Diagnostics Laboratory can be contacted via phone (949) 824-1886, or through Wallace, Douglas C. via phone (949) 824-3490.

Contact Information

Primary practice address
2501 Hewitt Hl University Of California Irvine Irvine CA 92697-0001
Phone: (949) 824-1886
Fax: (949) 824-6388
Website:
Map and Directions
Authorized official contact:
Name: Wallace, Douglas C. PHD
Phone: (949) 824-3490

Health care specialties

SpecialtyCodeLicense #State
Laboratories / Clinical Medical Laboratory 291U00000X 05D1034314 California

Profile Details

NPI number 1356595011
LBN Legal business name Mitomed Diagnostics Laboratory
DBA Doing business as
Authorized official Wallace, Douglas C. PHD
Entity Organization
Organization subpart 1 No
Enumeration date Nov 7th, 2008
Last updated Nov 7th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356595011 NPPES
California Other 05D1034314 CLIA

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