Organization
LIBERTY 2000 LLC
Active
Other names
Liberty Labs
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEREK TRAN JD (PROPRIETOR)
(714) 306-3013
Entity
Organization
Contact information
Practice address
10760 WARNER AVE, 201, FOUNTAIN VALLEY, CA 92708-3845
(714) 593-5356
(714) 593-5366
Mailing address
10760 WARNER AVE, 201, FOUNTAIN VALLEY, CA 92708-3845
(714) 593-5356
(714) 593-5366
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D2057214
CLIA
CA
Enumeration date
11/19/2013
Last updated
11/19/2013
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