Lab PRC LLC

Primary specialty

Infusion Therapy Registered NurseTaxonomy code 163WI0500X

License

95118857 Issued in CA

Legal business name

LAB PRC LLC

Practice address

27901 Jefferson Ave Ste 101
Temecula, CA 92590-6613

Phone

(951) 394-2653

NPI assigned

Jun 29, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jaci Clawson

Title

Managing Partner

Phone

(951) 394-2653

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530230400000",
    "number": "1013402163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27901 JEFFERSON AVE STE 101",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925906613",
            "telephone_number": "951-394-2653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27901 JEFFERSON AVE STE 101",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925906613",
            "telephone_number": "951-394-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAB PRC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-29",
        "last_updated": "2018-06-29",
        "status": "A",
        "authorized_official_last_name": "CLAWSON",
        "authorized_official_first_name": "JACI",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "951-394-2653"
    },
    "taxonomies": [
        {
            "code": "163WI0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "CA",
            "license": "95118857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Temecula, CA
• Infusion Therapy Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.