Provider First Line Business Practice Location Address:
4580 ELECTRONICS PL
Provider Second Line Business Practice Location Address:
SCPMG GENETIC TESTING
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90039-1008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-502-5959
Provider Business Practice Location Address Fax Number:
818-502-5921
Provider Enumeration Date:
01/10/2006