Crestview Clinical Laboratory

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

CRESTVIEW CLINICAL LABORATORY

Practice address

1471 S Riverside Ave
Rialto, CA 92376-7703

Phone

(909) 877-1361

NPI assigned

Aug 11, 2006

Organization subpart

No

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

Authorized official

Name

Leona Berglund

Title

Administrator

Phone

(909) 877-1361

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Crestview Convalescent Hospital3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Crestview Clinical Laboratory

  • Clinical Medical Laboratory
  • Rialto, CA
  • NPI 1154557213
  NPD tax ID
• Crestview Convalescent Hospital

  • Skilled Nursing Facility
  • Rialto, CA
  • NPI 1255340592
  NPD tax ID

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285645226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1471 S RIVERSIDE AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923767703",
            "telephone_number": "909-877-1361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1471 S RIVERSIDE AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923767703",
            "telephone_number": "909-877-1361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTVIEW CLINICAL LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERGLUND",
        "authorized_official_first_name": "LEONA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "909-877-1361"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN NUMBER",
            "identifier": "LAB64416F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dale Marie Craig
• Cranes Medical Transportation LLC
• Venus Cassiopeia Craver
• Lorraine Jacquelyn Crawford
• Crestview Clinical Laboratory
• Crestview Convalescent Hospital
• Bridgette Croney
• Cheyann R Cross
• Shena Crowe
• Alberto Marcelino Cruz, MD

• Clinical Medical Laboratory in Rialto, CA
• Providers in Rialto, 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 22, 2020; 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.