Organization
MGPL INC
Active
Other names
Medical Group Pathology Lab
Organization subpart
No
Provider details
NPI number
Authorized official
PETER L MORRIS MD (PRESIDENT)
(805) 563-1800
Entity
Organization
Contact information
Practice address
4181 STATE STREET, SANTA BARBARA, CA 93110
(805) 563-1800
(805) 569-6233
Mailing address
PO BOX 25420, VENTURA, CA 93002-2277
(805) 650-5910
(805) 650-5972
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
05D0920409
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0920409
CLIA
CA
05
—
LAB20409F
—
CA
01
—
ZZZ528082
BLUE SHIELD OF CA
CA
Enumeration date
11/27/2006
Last updated
05/02/2008
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