MEDICARE: SAPPHIROS LABORATORIES CA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1437810108
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAPPHIROS LABORATORIES CA LLC

Provider Business Mailing Address
First Line	:	2688 MIDDLEFIELD RD STE A
Second Line	:
City	:	REDWOOD CITY
State	:	CA
Zip	:	94063-3483
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2688 MIDDLEFIELD RD STE A
Second Line	:
City	:	REDWOOD CITY
State	:	CA
Zip	:	94063-3483
Country	:	US
Telephone Number	:	800-438-9516
Fax Number	:

Authorized Official
Title or Position	:	GENERAL COUNSEL
Name	:	MICHAEL ROBBAT
Credential	:
Telephone Number	:	617-519-6626

Provider Enumeration Date	:	01/05/2022
Last Update Date	:	01/05/2022

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