Organization
I2B LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GOWRIHARAN THAIYANANTHAN (OWNER)
(203) 376-6364
Entity
Organization
Contact information
Practice address
4631 TELLER AVE, SUITE 100, NEWPORT BEACH, CA 92660-8105
(949) 335-7510
Mailing address
4631 TELLER AVE, SUITE 100, NEWPORT BEACH, CA 92660-8105
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF 00344005
CA
Other
Enumeration date
06/13/2013
Last updated
06/13/2013
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