Organization
LINCOLN CLINICAL DIAGNOSTIC LABORATORY
Active
Other names
N/A
Organization subpart
No
Provider details
NPI number
Authorized official
HOWARD W OLIVER M.D. (LABORATORY DIRECTOR)
(714) 635-2430
Entity
Organization
Contact information
Practice address
520 N BROOKHURST ST, SUITE #121, ANAHEIM, CA 92801-5227
(714) 635-2430
(714) 635-4138
Mailing address
520 N BROOKHURST ST, SUITE #121, ANAHEIM, CA 92801-5227
(714) 635-2430
(714) 635-4138
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF00339715
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D2007832
CLIA ID NUMBER
CA
01
—
20A5179
LICENSE
CA
01
—
CLF00339715
LAB LICENSE
CA
Enumeration date
08/02/2010
Last updated
05/08/2012
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