Healthcare Provider Details

I. General information

NPI: 1245167972
Provider Name (Legal Business Name): PRIMEDRAW SPECIMENS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3579 ARLINGTON AVE STE 80053
RIVERSIDE CA
92506-3915
US

IV. Provider business mailing address

3579 ARLINGTON AVE STE 80053
RIVERSIDE CA
92506-3915
US

V. Phone/Fax

Practice location:
  • Phone: 833-909-0620
  • Fax:
Mailing address:
  • Phone: 833-909-0620
  • 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: ANTHONY JIMENEZ
Title or Position: CEO
Credential: CPT 1
Phone: 833-909-0620