Organization
FERTILITY LAB SCIENCES OF ORANGE COUNTY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON PARDEW (CHIEF EXECUTIVE OFFICE)
(303) 968-1950
Entity
Organization
Contact information
Practice address
3501 JAMBOREE RD STE 450, NEWPORT BEACH, CA 92660-2916
(949) 531-6331
Mailing address
9380 STATION ST, LONE TREE, CO 80124-6831
(860) 303-8855
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D2089497
CLIA
—
Enumeration date
11/19/2020
Last updated
11/19/2020
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