Organization
ONCOTECH INC
Active
Other names
Exiqon Diagnostics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK WILLIG (CHIEF COMMERCIAL OFFICER)
(714) 566-0470
Entity
Organization
Contact information
Practice address
15501 RED HILL AVENUE, TUSTIN, CA 92780
(714) 566-0420
(714) 566-0471
Mailing address
15501 RED HILL AVENUE, TUSTIN, CA 92780
(714) 566-0420
(714) 566-0471
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
4785-STATE LICENSE
CA
291U00000X
Clinical Medical Laboratory
CLF 4785
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00768644A
—
GA
05
—
01464390
—
PA
05
—
030483200
—
FL
05
—
0805289
—
MD
05
—
100245170A
—
KS
05
—
100384230A
—
IN
05
—
125472709
—
AK
05
—
160820
—
AZ
05
—
37903010
—
KY
05
—
4490705
—
TN
05
—
6228003
—
NJ
05
—
7001073
—
NC
05
—
7060627
—
WA
05
—
707653606
—
MO
05
—
98002652
—
CO
05
—
L00034
—
SC
05
—
LAB09008F
—
CA
05
—
X059008
—
CA
Enumeration date
08/17/2006
Last updated
02/08/2010
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