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Organization

CPA LAB CLINIC ASSOCIATES INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISAEL GONZALEZ (CEO)
(502) 326-5845
Entity
Organization

Contact information

Practice address
2307 GREENE WAY, LOUISVILLE, KY 40220
(502) 326-5845
Mailing address
2658 GRIFFITH PARK BLVD, STE 125, LOS ANGELES, CA 90039

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
18D1066325
KY

Other

Enumeration date
10/21/2010
Last updated
10/21/2010
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