Organization
OPTIMUM BIO LAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VINCENZO SORRENTINO (PRESIDENT / CEO)
(951) 465-3600
Entity
Organization
Contact information
Practice address
1910 S ARCHIBALD AVE #D, ONTARIO, CA 91761
(951) 465-3600
(951) 231-9838
Mailing address
1910 S ARCHIBALD AVE #D, ONTARIO, CA 91761
(951) 465-3600
(951) 231-9838
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D2155298
CLIA
CA
Enumeration date
02/07/2018
Last updated
02/19/2020
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