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General NPI Number Information
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NPI Number | 1366086449
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Entity Type | Organization
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Legal Business Name | EVIA DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 11/01/2019
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Last Update Date | 06/10/2020
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Provider Practice Location Address
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Address Line | 3237 ALHAMBRA AVE STE 2
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City | MARTINEZ
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State | CA
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Zip | 94553-3124
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Country | US
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Telephone | 650-400-0009
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Fax |
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Provider Business Mailing Address
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Address Line | 446 OLD COUNTY RD STE 100-340
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City | PACIFICA
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State | CA
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Zip | 94044-3270
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MAYA N PATEL
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Credential |
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Telephone | 650-400-0009
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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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