Healthcare Provider Details

I. General information

NPI: 1831564483
Provider Name (Legal Business Name): BIO GENETISYS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2015
Last Update Date: 12/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

471 W LAMBERT RD SUITE 104
BREA CA
92821-3921
US

IV. Provider business mailing address

471 W LAMBERT RD SUITE 104
BREA CA
92821-3921
US

V. Phone/Fax

Practice location:
  • Phone: 714-257-9344
  • Fax: 714-257-9348
Mailing address:
  • Phone: 714-257-9344
  • Fax: 714-257-9348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License NumberCLF348708
License Number StateCA

VIII. Authorized Official

Name: MRS. KATERINA A KARAPETYAN
Title or Position: PRESIDENT
Credential:
Phone: 714-257-9344