Organization
CRESTVIEW CLINICAL LABORATORY
Active
Parent organization
CRESTVIEW CONVALESCENT HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
CRESTVIEW CONVALESCENT HOSPITAL
Authorized official
MRS. LEONA JUNE BERGLUND (ADMINISTRATOR)
(909) 877-1361
Entity
Organization
Contact information
Practice address
1471 S RIVERSIDE AVE, RIALTO, CA 92376-7703
(909) 877-1361
(909) 877-0854
Mailing address
1471 S RIVERSIDE AVE, RIALTO, CA 92376-7703
(909) 877-1361
(909) 877-0854
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF 11381
CA
Other
Enumeration date
06/03/2009
Last updated
06/03/2009
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