Active NPI
Lincoln Clinical Diagnostic Laboratory
- Clinical Medical Laboratory
- Anaheim, CA
National Provider Identifier
1861706897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- CLF00339715
- Legal business name
- LINCOLN CLINICAL DIAGNOSTIC LABORATORY
- Practice address
- 520 N Brookhurst St
Suite #121
Anaheim, CA 92801-5227 - Phone
- (714) 635-2430
- Fax
- (714) 635-4138
- NPI assigned
- Aug 2, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Howard W Oliver, M.D.
- Title
- Laboratory Director
- Phone
- (714) 635-2430
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | CLF00339715 | CA | Primary |
Addresses
Primary practice location
520 N Brookhurst St
Suite #121
Anaheim, CA 92801-5227
Mailing address
520 N Brookhurst St
Suite #121
Anaheim, CA 92801-5227
Phone (714) 635-2430
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05D2007832 | Other | CA | CLIA ID NUMBER |
| 20A5179 | Other | CA | LICENSE |
| CLF00339715 | Other | CA | LAB LICENSE |
Other names 1
- N/A
National Provider Directory
National Provider DirectoryLocations
520 N Brookhurst St
Ste 121
Anaheim, CA 92801
Phone (714) 635-2430
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280707200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1336435200000",
"number": "1861706897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 N BROOKHURST ST",
"address_2": "SUITE #121",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928015227",
"telephone_number": "714-635-2430",
"fax_number": "714-635-4138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 N BROOKHURST ST",
"address_2": "SUITE #121",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928015227",
"telephone_number": "714-635-2430",
"fax_number": "714-635-4138"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LINCOLN CLINICAL DIAGNOSTIC LABORATORY",
"organizational_subpart": "NO",
"enumeration_date": "2010-08-02",
"last_updated": "2012-05-08",
"status": "A",
"authorized_official_last_name": "OLIVER",
"authorized_official_first_name": "HOWARD",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "LABORATORY DIRECTOR",
"authorized_official_telephone_number": "714-635-2430",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "CA",
"license": "CLF00339715",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA ID NUMBER",
"identifier": "05D2007832",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "20A5179",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LAB LICENSE",
"identifier": "CLF00339715",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "N/A",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.