Organization
DIRECT DIAGNOSTIC LABS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SPENCER MOFFATT PHD (SENIOR VP)
(651) 315-5157
Entity
Organization
Contact information
Practice address
2701 OCEAN PARK BLVD STE 114, SANTA MONICA, CA 90405-5200
(651) 315-5157
Mailing address
2701 OCEAN PARK BLVD STE 114, SANTA MONICA, CA 90405-5200
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
03/03/2022
Last updated
04/07/2022
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