Organization
CRESTVIEW CLINICIAL LABORATORY
Active
Organization
CRESTVIEW CLINICIAL LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KITTY WEN (DIRECTOR OF OPERATIONS)
(909) 594-7507
Entity
Organization
Contact information
Practice address
3220 BREA CANYON RD, STE B, DIAMOND BAR, CA 91765-3481
(909) 594-7507
Mailing address
3220 BREA CANYON RD, STE B, DIAMOND BAR, CA 91765-3481
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285645226
NEW NPI APPLICATION
CA
Enumeration date
08/08/2011
Last updated
08/08/2011
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