Crestview Clinicial Laboratory

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

CRESTVIEW CLINICIAL LABORATORY

Practice address

3220 Brea Canyon Rd
Ste B
Diamond Bar, CA 91765-3481

Phone

(909) 594-7507

NPI assigned

Aug 8, 2011

Last updated

Aug 8, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kitty Wen

Title

Director of Operations

Phone

(909) 594-7507

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312761600000",
    "number": "1053690123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 BREA CANYON RD",
            "address_2": "STE B",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917653481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 BREA CANYON RD",
            "address_2": "STE B",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917653481",
            "telephone_number": "909-594-7507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTVIEW CLINICIAL LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-08",
        "last_updated": "2011-08-08",
        "status": "A",
        "authorized_official_last_name": "WEN",
        "authorized_official_first_name": "KITTY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "909-594-7507"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW NPI APPLICATION",
            "identifier": "1285645226",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Jane Couch, LMFT
• Country Medical Corporation
• Robert Cousins, LHAD
• Jessica Crane, DPT
• Crescent Med Trans
• Crestview Recovery Center, LLC
• Olivia Laura Cruz
• CS&KT Lee LLC
• Czarinne a Fetalino DMD Inc
• Rawasi Daloub

• Clinical Medical Laboratory in Diamond Bar, CA
• Providers in Diamond Bar, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2011; 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.