Organization
COMMUNITY DIAGNOSTIC LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE WILSON (OPERATIONS MANAGER)
(626) 305-5709
Entity
Organization
Contact information
Practice address
1941 WALKER AVE, MONROVIA, CA 91016-4846
(626) 305-5709
Mailing address
1941 WALKER AVE, MONROVIA, CA 91016-4846
(626) 305-5709
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF10748
CA
Other
Enumeration date
03/08/2007
Last updated
08/22/2020
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