Organization
MS DIAGNOSTIC LABORATORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MONTANO DELEON GERONIMO JR. (OWNER/LABORATORY MANAGER)
(626) 840-2870
Entity
Organization
Contact information
Practice address
1928 E CENTER ST, ANAHEIM, CA 92805-3408
(626) 840-2870
(626) 445-4612
Mailing address
1928 E CENTER ST, ANAHEIM, CA 92805-3408
(626) 840-2870
(626) 445-4612
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF00341934
CA
Other
Enumeration date
01/02/2012
Last updated
06/27/2012
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