Organization
DUZ MOR DIAGNOSTIC LAB INC
Active
Other names
pacific medical lab
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOE L MOREHEAD (PRESIDENT)
(323) 971-0635
Entity
Organization
Contact information
Practice address
2700 W MANCHESTER BLVD, INGLEWOOD, CA 90305-2436
(323) 758-5161
Mailing address
2700 W MANCHESTER BLVD, INGLEWOOD, CA 90305-2436
(323) 758-5161
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF3216
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ59345Z
—
CA
Enumeration date
06/20/2005
Last updated
08/22/2020
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