Organization
BLUEBIO USA LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDA MACK (PRESIDENT)
(949) 822-3303
Entity
Organization
Contact information
Practice address
1 PETERS CANYON RD STE 160, IRVINE, CA 92606-1748
(949) 822-3303
(949) 223-1887
Mailing address
1 PETERS CANYON RD STE 160, IRVINE, CA 92606-1748
(949) 822-3303
(949) 223-1887
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D2222409
FEDERAL CLIA LICENSE
—
01
—
CDF-900003500
STATE CLIA LICENSE
CA
Enumeration date
02/14/2022
Last updated
11/18/2022
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