Organization Active NPI

Palomar Health

Doing business as Palomar Health Laboratory Services - PMC Poway

  • Clinical Medical Laboratory
  • Poway, CA
National Provider Identifier
1811245863
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
3150 Issued in CA
Legal business name
PALOMAR HEALTH
Doing business as
Palomar Health Laboratory Services - PMC Poway
Practice address
15615 Pomerado Rd
Poway, CA 92064-2405
Phone
(858) 613-4703
NPI assigned
Aug 23, 2012
Last updated
Mar 9, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
PALOMAR HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Authorized official

Name
Diane Hansen
Title
President and Ceo
Phone
(760) 740-6385

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 3150 CA Primary

Addresses

Primary practice location

15615 Pomerado Rd
Poway, CA 92064-2405

Mailing address

2125 Citracado Pkwy Ste 300
Escondido, CA 92029-4159

Other names 1

  • Palomar Health Laboratory Services - PMC Poway Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0668540Pomerado Hospital Laboratory15615 Pomerado Road, Poway, CA 92064AccreditationApr 27, 2027

National Provider Directory

National Provider Directory
Tax ID family
Pomerado Hospital Phcy14 organizations share this tax ID, including this one
Part of
Pomerado Hospital Phcy

Other organizations with this tax ID 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1345680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615248000000",
    "number": "1811245863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 CITRACADO PKWY STE 300",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920294159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15615 POMERADO RD",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642405",
            "telephone_number": "858-613-4703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALOMAR HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALOMAR HEALTH",
        "enumeration_date": "2012-08-23",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "760-740-6385"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "3150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palomar Health Laboratory Services - PMC Poway",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Palomar Health Laboratory Services - PMC Poway",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poway, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.