Organization
MPOL LABORATORY LLC
Active
Other names
MPOL LABORATORY LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AHSAN BASEER PH.D. (OWNER)
(951) 735-9190
Entity
Organization
Contact information
Practice address
1888 W 6TH ST, SUITE H, CORONA, CA 92882-2993
(951) 735-9190
(951) 340-2846
Mailing address
1888 W 6TH ST, SUITE H, CORONA, CA 92882-2993
(951) 735-9190
(951) 340-2846
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF4840
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0543719
CLIA ID
CA
01
—
LAB54371G
MEDI-CAL
CA
Enumeration date
07/02/2007
Last updated
06/19/2008
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