Organization Active NPI

Trinity Laboratory Enterprises, LLC

  • Clinical Medical Laboratory
  • Santa Ana, CA
National Provider Identifier
1245460401
Registry record updated Jul 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
05D0580755 Issued in CA
Legal business name
TRINITY LABORATORY ENTERPRISES, LLC
Practice address
1125 E 17TH St
Suite N-156
Santa Ana, CA 92701-2201
Phone
(818) 554-1547
NPI assigned
Jul 22, 2009
Last updated
Jul 22, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2009

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

Authorized official

Name
John Mi Austin
Title
Managing Member
Phone
(818) 554-1547

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 05D0580755 CA Primary

Addresses

Primary practice location

1125 E 17TH St
Suite N-156
Santa Ana, CA 92701-2201

Mailing address

508 S Verdugo Dr
2ND Floor
Burbank, CA 91502-2344
Phone (818) 554-1547

Other identifiers 1

IdentifierTypeStateIssuer
05D0580755OtherCACLIA

National Provider Directory

National Provider Directory

Locations

508 S Verdugo Dr
Fl 2
Burbank, CA 91502

NPI Registry JSON

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248220800000",
    "number": "1245460401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 S VERDUGO DR",
            "address_2": "2ND FLOOR",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915022344",
            "telephone_number": "818-554-1547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 E 17TH ST",
            "address_2": "SUITE N-156",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927012201",
            "telephone_number": "818-554-1547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY LABORATORY ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-22",
        "last_updated": "2009-07-22",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MI",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "818-554-1547"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "05D0580755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D0580755",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; 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.