Provider Demographics
NPI:1215718168
Name:ACCULAB INC
Entity type:Organization
Organization Name:ACCULAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZEYAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ABULATHOA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-200-5054
Mailing Address - Street 1:4171 BALL RD # 174
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-3465
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3194 AIRPORT LOOP DR STE A
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-3405
Practice Address - Country:US
Practice Address - Phone:888-787-8210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory