Provider Demographics
NPI:1174906432
Name:PHLEBXPRESS
Entity type:Organization
Organization Name:PHLEBXPRESS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:LORRAINE
Authorized Official - Last Name:HAZARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-396-9447
Mailing Address - Street 1:32819 TEMECULA PKWY
Mailing Address - Street 2:STE. A
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-4671
Mailing Address - Country:US
Mailing Address - Phone:877-396-9447
Mailing Address - Fax:877-476-6158
Practice Address - Street 1:32819 TEMECULA PKWY
Practice Address - Street 2:STE. A
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-9259
Practice Address - Country:US
Practice Address - Phone:877-396-9447
Practice Address - Fax:877-476-6158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-06
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory