Healthcare Provider Details

I. General information

NPI: 1609748730
Provider Name (Legal Business Name): LEMEDIX NORCAL LAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2025
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5757 SONOMA DR STE AA
PLEASANTON CA
94566-7758
US

IV. Provider business mailing address

5757 SONOMA DR STE AA
PLEASANTON CA
94566-7758
US

V. Phone/Fax

Practice location:
  • Phone: 949-531-6062
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MIKAIL AHMAD
Title or Position: CEO
Credential:
Phone: 949-531-6062