Life Technologies Clinical SVCS Lab Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

05D1067109 Issued in CA

Legal business name

LIFE TECHNOLOGIES CLINICAL SVCS LAB INC.

Practice address

910 Riverside Parkway
Suite 60
West Sacramento, CA 95605-1510

Phone

(888) 734-8588

Fax

(855) 896-0909

NPI assigned

Oct 31, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Alan Eugene Wells Sr.

Title

Sr. Manager Laboratory Operations

Phone

(760) 717-6239

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395100800000",
    "number": "1306190129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 RIVERSIDE PARKWAY",
            "address_2": "SUITE 60",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956051510",
            "telephone_number": "888-734-8588",
            "fax_number": "855-896-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 RIVERSIDE PARKWAY",
            "address_2": "SUITE 60",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956051510",
            "telephone_number": "888-734-8588",
            "fax_number": "855-896-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE TECHNOLOGIES CLINICAL SVCS LAB INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-31",
        "last_updated": "2014-03-18",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "SR. MANAGER LABORATORY OPERATIONS",
        "authorized_official_telephone_number": "760-717-6239",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "05D1067109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Minyoung Lee, D.M.D.
• Heather Leo, DDS
• Nathaly Cecilia Leon
• Janneth Liborio-Lulo, LCSW
• Edwin Alphonse Lichwa II, D.O.
• Lifeline E-Transport LLC
• Neal Liggins
• Tina Lilliedoll
• Yi-Chern Lin
• Kevin C Lindblom, PT

• Clinical Medical Laboratory in West Sacramento, CA
• Providers in West Sacramento, 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 Mar 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.