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General NPI Number Information
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NPI Number | 1306418934
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Entity Type | Organization
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Legal Business Name | REOPEN DIAGNOSTICS LLC
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Dates
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Enumeration Date | 07/13/2021
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Last Update Date | 08/18/2021
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Provider Practice Location Address
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Address Line | 131 INNOVATION DR STE 150
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City | IRVINE
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State | CA
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Zip | 92617-3037
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Country | US
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Telephone | 651-253-7349
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Fax |
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Provider Business Mailing Address
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Address Line | 430 E 29TH ST FL 12
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City | NEW YORK
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State | NY
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Zip | 10016-8367
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Country | US
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Telephone | 541-253-7349
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JONATHAN BADAL
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Credential |
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Telephone | 347-831-3555
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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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