Healthcare Provider Details

I. General information

NPI: 1447169776
Provider Name (Legal Business Name): AGEN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3121 BROADWAY
SACRAMENTO CA
95817-1926
US

IV. Provider business mailing address

3121 BROADWAY
SACRAMENTO CA
95817-1926
US

V. Phone/Fax

Practice location:
  • Phone: 279-263-4266
  • Fax:
Mailing address:
  • Phone: 279-263-4266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RM2200X
TaxonomyMedical Laboratory Technician
License Number
License Number State

VIII. Authorized Official

Name: ALIK ARAKELYAN
Title or Position: OWNER
Credential:
Phone: 279-263-4266