Organization
MEDICAL LABORATORY SERVICES MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERNEST HOLBURT (CEO)
(951) 834-9020
Entity
Organization
Contact information
Practice address
40663 MURRIETA HOT SPRINGS RD STE C1, MURRIETA, CA 92562-9015
(951) 834-9020
(951) 834-9026
Mailing address
PO BOX 2740, FALLBROOK, CA 92088-2740
(805) 250-9233
(805) 578-3911
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G471370
—
CA
05
—
GR0092911
—
CA
Enumeration date
05/17/2007
Last updated
11/07/2023
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