Organization
WHITEFIELD MEDICAL LABORATORY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JATIN LAXPATI (CHIEF EXECUTIVE OFFICER)
(909) 625-2114
Entity
Organization
Contact information
Practice address
764 INDIGO COURT, #A, POMONA, CA 91767
(909) 625-2114
(909) 625-7735
Mailing address
764 INDIGO COURT, #A, POMONA, CA 91767
(909) 625-2114
(909) 625-7735
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLIA 05D0716660
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB04252F
—
CA
Enumeration date
10/05/2006
Last updated
04/27/2009
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