Provider Demographics
NPI:1124752480
Name:NEWPORT DIAGNOSTICS LABORATORY
Entity type:Organization
Organization Name:NEWPORT DIAGNOSTICS LABORATORY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:HINSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-468-8447
Mailing Address - Street 1:18242 MCDURMOTT W STE C
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-4773
Mailing Address - Country:US
Mailing Address - Phone:949-385-3535
Mailing Address - Fax:949-528-1313
Practice Address - Street 1:18242 MCDURMOTT W STE C
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-4773
Practice Address - Country:US
Practice Address - Phone:949-309-1632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-13
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory