Organization
LAB PRC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACI CLAWSON (MANAGING PARTNER)
(951) 394-2653
Entity
Organization
Contact information
Practice address
27901 JEFFERSON AVE STE 101, TEMECULA, CA 92590-6613
(951) 394-2653
Mailing address
27901 JEFFERSON AVE STE 101, TEMECULA, CA 92590-6613
(951) 394-2653
Taxonomy
Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
Primary
95118857
CA
Other
Enumeration date
06/29/2018
Last updated
06/29/2018
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