Organization
TRINITY LABORATORY ENTERPRISES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MI AUSTIN (MANAGING MEMBER)
(818) 554-1547
Entity
Organization
Contact information
Practice address
1125 E 17TH ST, SUITE N-156, SANTA ANA, CA 92701-2201
(818) 554-1547
Mailing address
508 S VERDUGO DR, 2ND FLOOR, BURBANK, CA 91502-2344
(818) 554-1547
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
05D0580755
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0580755
CLIA
CA
Enumeration date
07/22/2009
Last updated
07/22/2009
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