Organization
ADJ CORPORATION
Active
Other names
WEST PACIFIC MEDICAL LABORATORY
Organization subpart
No
Provider details
NPI number
Authorized official
DAN ENDOSO (PRESIDENT)
(562) 906-5227
Entity
Organization
Contact information
Practice address
10200 PIONEER BLVD, SUITE 500, SANTA FE SPRINGS, CA 90670-6000
(562) 906-5227
(562) 906-6450
Mailing address
PO BOX 2339, SANTA FE SPRINGS, CA 90670-0339
(562) 906-5227
(562) 906-6450
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF 10371
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0866459
CLIA NUMBER
CA
01
—
CLF 10371
CLINICAL LABORATORY LIC
CA
05
—
LAB76459F
—
CA
Enumeration date
07/07/2006
Last updated
04/21/2010
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