Organization
MPOL LABORATORY LLC
Active
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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