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General NPI Number Information
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NPI Number | 1245944487
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Entity Type | Organization
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Legal Business Name | BAY MOBILE DIAGNOSTICS & LAB SERVICES, LLC
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Dates
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Enumeration Date | 01/12/2023
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 1401 21ST ST STE R
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City | SACRAMENTO
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State | CA
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Zip | 95811-5226
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Country | US
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Telephone | 415-508-7296
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Fax |
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Provider Business Mailing Address
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Address Line | 1401 21ST ST STE R
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City | SACRAMENTO
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State | CA
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Zip | 95811-5226
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Country | US
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Telephone | 415-508-7296
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DJINAFLOWERS VILLETTE
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Credential |
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Telephone | 678-933-4163
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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