Provider Demographics
NPI:1053462507
Name:MEDICAL SCIENCES LABORATORY INC.
Entity type:Organization
Organization Name:MEDICAL SCIENCES LABORATORY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB. MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHINDER
Authorized Official - Middle Name:PAL SINGH
Authorized Official - Last Name:GANDHI
Authorized Official - Suffix:
Authorized Official - Credentials:CLS
Authorized Official - Phone:714-778-0281
Mailing Address - Street 1:PO BOX 4662
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92803-4662
Mailing Address - Country:US
Mailing Address - Phone:714-778-0281
Mailing Address - Fax:714-778-2220
Practice Address - Street 1:1761 W ROMNEYA DR STE A
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1816
Practice Address - Country:US
Practice Address - Phone:714-778-0281
Practice Address - Fax:714-778-2220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACLF10868291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALAB94010FMedicaid