Organization
UNIVERSITY OF SOUTHERN CALIFORNIA
Active
Parent organization
UNIVERSITY OF SOUTHERN CALIFORNIA
Other names
USC REPRODUCTIVE ENDOCRINE LABORATORY
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNIVERSITY OF SOUTHERN CALIFORNIA
Authorized official
TODD DICKEY (SR VP ADMINISTRATION)
(213) 740-8184
Entity
Organization
Contact information
Practice address
1321 NORTH MISSION ROAD, LRB 207 AND 208, LOS ANGELES, CA 90033
(323) 224-5590
(323) 225-4035
Mailing address
PO BOX 513199, LOS ANGELES, CA 90051-1199
(323) 224-5590
(323) 225-4035
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
05D1033782
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D1033782
CLIA
CA
01
—
690000015
MEDICARE RAILROAD
CA
01
—
CLF33196
STATE
CA
05
—
LAB33782F
—
CA
Enumeration date
03/14/2007
Last updated
09/18/2015
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