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Organization

CALIFORNIA STAT LABORATORIES

Active
Other names
IndiviDx
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KURT JOSE MSC (PRESIDENT/CEO)
(909) 809-1494
Entity
Organization

Contact information

Practice address
1350 FOOTHILL BLVD, LA VERNE, CA 91750-3332
(909) 219-4131
(909) 512-6492
Mailing address
PO BOX 638, LA VERNE, CA 91750-0638
(909) 219-4131
(909) 512-6492

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF 347539
CA

Other

Enumeration date
04/29/2015
Last updated
02/23/2018
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