Innovative Bioanalysis, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CDF335544 Issued in CA

Legal business name

INNOVATIVE BIOANALYSIS, LLC

Practice address

5630 Cerritos Ave
Cypress, CA 90630-4738

Phone

(949) 338-8325

NPI assigned

Feb 12, 2018

Last updated

Feb 12, 2018By 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

Mr. Kevin Carl Noble

Title

Owner

Phone

(949) 338-8325

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1518393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518393600000",
    "number": "1619476033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27662 ALISO CREEK RD APT 9313",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926565815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5630 CERRITOS AVE",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906304738",
            "telephone_number": "949-338-8325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE BIOANALYSIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-12",
        "last_updated": "2018-02-12",
        "status": "A",
        "authorized_official_last_name": "NOBLE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "CARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-338-8325",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CDF335544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAP",
            "identifier": "9501843",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• You Ri Hwang
• Cassandra Ibarra, OTR/L
• Reynaldo Bennett Igliane Jr., ATC, CSCS, EMT-B
• Sharon Sumi Im-Lee, M.S., CCC-SLP
• Miranda Rose Infante
• Interactive Medical Systems, Inc.
• Kelechi Irondi, NPC
• Kevin Ishizu
• Alexa Islas
• Miguel Ituralde, DPT

• Clinical Medical Laboratory in Cypress, CA
• Providers in Cypress, 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 Feb 12, 2018; 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.