Provider Demographics
NPI:1912104761
Name:RADIATA LABORATORIES LLC
Entity type:Organization
Organization Name:RADIATA LABORATORIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:C
Authorized Official - Last Name:MAGARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-738-2229
Mailing Address - Street 1:1810 FULLERTON AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-3103
Mailing Address - Country:US
Mailing Address - Phone:951-738-2229
Mailing Address - Fax:951-738-2222
Practice Address - Street 1:4900 BARRANCA PKWY
Practice Address - Street 2:SUITE 104
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-8603
Practice Address - Country:US
Practice Address - Phone:949-726-0682
Practice Address - Fax:949-653-1852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory