Optimum Bio Lab Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

OPTIMUM BIO LAB INC

Practice address

1910 S Archibald Ave #D
Ontario, CA 91761

Phone

(951) 465-3600

Fax

(951) 231-9838

NPI assigned

Feb 7, 2018

Last updated

Feb 19, 2020By 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

Vincenzo Sorrentino

Title

President / Ceo

Phone

(951) 465-3600

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1517961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582070400000",
    "number": "1801395595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 S ARCHIBALD AVE #D",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "91761",
            "telephone_number": "951-465-3600",
            "fax_number": "951-231-9838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 S ARCHIBALD AVE #D",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "91761",
            "telephone_number": "951-465-3600",
            "fax_number": "951-231-9838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM BIO LAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-07",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A",
        "authorized_official_last_name": "SORRENTINO",
        "authorized_official_first_name": "VINCENZO",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "951-465-3600"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D2155298",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Ontario, CA
• Providers in Ontario, 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 19, 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.