Imperial Clinical Laboratory Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CLF 10598 Issued in CA

Legal business name

IMPERIAL CLINICAL LABORATORY INC

Practice address

7291 Heil Ave
Huntington Beach, CA 92647-0000

Phone

(714) 375-0800

Fax

(714) 375-0814

NPI assigned

Feb 19, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Luke Watson, M.D.

Title

Medical Director

Phone

(714) 375-0800

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1386788594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7291 HEIL AVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926474467",
            "telephone_number": "714-375-0800",
            "fax_number": "714-375-0814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7291 HEIL AVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926470000",
            "telephone_number": "714-375-0800",
            "fax_number": "714-375-0814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPERIAL CLINICAL LABORATORY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "LUKE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "714-375-0800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLF 10598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB85332H",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABORATORY ID NUMBER",
            "identifier": "CLF10598",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chad Allan Infante, PTA
• Infusion Medical Group PC
• Infusion of Care Inc, a California Corporation
• Chansophourn Ing
• Initial Innovative Blood, LLC

• Clinical Medical Laboratory in Huntington Beach, CA
• Providers in Huntington Beach, 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 7, 2008; 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.