Provider Demographics
NPI:1164259214
Name:PACIFIC TOXICOLOGY LABORATORIES
Entity type:Organization
Organization Name:PACIFIC TOXICOLOGY LABORATORIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAKIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-678-4460
Mailing Address - Street 1:PO BOX 10076
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91410-0076
Mailing Address - Country:US
Mailing Address - Phone:805-578-8300
Mailing Address - Fax:805-578-3911
Practice Address - Street 1:231 CAPITOL ST STE 7
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-2200
Practice Address - Country:US
Practice Address - Phone:818-598-3110
Practice Address - Fax:818-598-3116
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PACIFIC TOXICOLOGY LABORATORIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory