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General NPI Number Information
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NPI Number | 1265529325
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Entity Type | Organization
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Legal Business Name | PRECISION DIAGNOSTIC LABORATORY, INC
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Dates
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Enumeration Date | 10/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 280 HOSPITAL CIR SUITE #108
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City | WESTMINSTER
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State | CA
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Zip | 92683-3977
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Country | US
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Telephone | 714-373-9484
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Fax | 714-373-9464
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Provider Business Mailing Address
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Address Line | 280 HOSPITAL CIR SUITE #108
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City | WESTMINSTER
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State | CA
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Zip | 92683-3977
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Country | US
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Telephone | 714-373-9484
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Fax | 714-373-9464
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MINH DA NGUYEN
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Credential |
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Telephone | 714-373-9484
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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 | CLF334845
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License Number State | CA
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