Provider Demographics
NPI:1265529325
Name:PRECISION DIAGNOSTIC LABORATORY, INC
Entity type:Organization
Organization Name:PRECISION DIAGNOSTIC LABORATORY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MINH
Authorized Official - Middle Name:DA
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-373-9484
Mailing Address - Street 1:280 HOSPITAL CIR
Mailing Address - Street 2:SUITE #108
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-3977
Mailing Address - Country:US
Mailing Address - Phone:714-373-9484
Mailing Address - Fax:714-373-9464
Practice Address - Street 1:280 HOSPITAL CIR
Practice Address - Street 2:SUITE #108
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-3977
Practice Address - Country:US
Practice Address - Phone:714-373-9484
Practice Address - Fax:714-373-9464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACLF334845291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory