Organization
IMPERIAL CLINICAL LABORATORY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUKE WATSON M.D. (MEDICAL DIRECTOR)
(714) 375-0800
Entity
Organization
Contact information
Practice address
7291 HEIL AVE, HUNTINGTON BEACH, CA 92647-0000
(714) 375-0800
(714) 375-0814
Mailing address
7291 HEIL AVE, HUNTINGTON BEACH, CA 92647-4467
(714) 375-0800
(714) 375-0814
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF 10598
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CLF10598
LABORATORY ID NUMBER
CA
05
—
LAB85332H
—
CA
Enumeration date
02/19/2007
Last updated
03/07/2008
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