Provider Demographics
NPI:1447938816
Name:THORNTON PACIFIC LABORATORIES
Entity type:Organization
Organization Name:THORNTON PACIFIC LABORATORIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:CONNOR
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-566-4009
Mailing Address - Street 1:4680 LASER RD
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:OH
Mailing Address - Zip Code:44875-9318
Mailing Address - Country:US
Mailing Address - Phone:419-566-4009
Mailing Address - Fax:
Practice Address - Street 1:861 6TH AVE SUITE 860
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101
Practice Address - Country:US
Practice Address - Phone:619-940-7577
Practice Address - Fax:619-923-5299
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THORNTON HOLDINGS INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory