Healthcare Provider Details

I. General information

NPI: 1497676548
Provider Name (Legal Business Name): PREMIER MOBILE LABS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 CITRUS ST
SANTA PAULA CA
93060-2339
US

IV. Provider business mailing address

304 CITRUS ST
SANTA PAULA CA
93060-2339
US

V. Phone/Fax

Practice location:
  • Phone: 805-794-5051
  • Fax:
Mailing address:
  • Phone: 805-794-5051
  • 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: DAMIAN RYAN GARCIA
Title or Position: OWNER
Credential: CPT
Phone: 805-794-5051