Organization
PATHOLOGY ARTS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CURTIS LEE TAGUE (CEO)
(951) 270-0605
Entity
Organization
Contact information
Practice address
549 QUEENSLAND CIR STE 101, CORONA, CA 92879-1397
(951) 270-0605
(951) 270-0675
Mailing address
PO BOX 800247, SANTA CLARITA, CA 91380-0247
(661) 705-3440
(661) 310-0478
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
05D1000595
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D1000595
CLIA
CA
01
—
CLF00011735
CLINICAL LAB LICENSE
CA
01
—
ZZZ67434Z
BLUE SHIELD/BLUE CROSS
—
Enumeration date
09/20/2006
Last updated
03/27/2024
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