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General NPI Number Information
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NPI Number | 1790598936
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Entity Type | Organization
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Legal Business Name | COMMUNITY TESTING
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Dates
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Enumeration Date | 01/30/2025
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Last Update Date | 01/17/2026
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Provider Practice Location Address
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Address Line | 750 STORY RD
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City | SAN JOSE
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State | CA
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Zip | 95122-2604
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Country | US
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Telephone | 408-555-1212
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Fax |
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Provider Business Mailing Address
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Address Line | 750 STORY RD
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City | SAN JOSE
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State | CA
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Zip | 95122-2604
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Country | US
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Telephone | 650-769-6548
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | VINCENT THAYER
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Credential |
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Telephone | 650-769-6548
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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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