Organization
SPECTRA CLINICAL LABORATORIES, INC
Active
Other names
SPECTRA CLINICAL LABORATORIES.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN L QUIMBY-JOHNSON (PRESIDENT AND CEO)
(949) 545-8738
Entity
Organization
Contact information
Practice address
5160 CAMPUS DR, NEWPORT BEACH, CA 92660-2101
(562) 776-8440
(562) 776-8070
Mailing address
PO BOX 755, REDONDO BEACH, CA 90277-0755
(562) 776-8440
(562) 776-8070
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF 10042
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB58836F
—
CA
01
—
X558836
MEDICARE PTAN #
CA
Enumeration date
08/16/2006
Last updated
09/28/2023
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