Agathos Laboratories, INC.
Clinical Medical Laboratory in Santa Clara, CA. Organization (NPI-2).
NPI number1154675742
StatusActive
Last updated in NPPESJan 21, 2014
Details
- NPI
- 1154675742
- Entity type
- Organization (NPI-2)
- Legal business name
- Agathos Laboratories, INC.
- Organization subpart
- No
- Enumeration date
- Nov 4, 2012
- Last updated
- Jan 21, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 291U00000X | Clinical Medical Laboratory | – | – | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | GH102230817 | CA | |
| 305S00000X | Point of Service | GH102230817 | CA | |
| 291900000X | Military Clinical Medical Laboratory | GH102230817 | CA |
Practice location
5201 Great America PkwySuite 320
Santa Clara, CA 95054-1122
Phone 408-730-6819 · Fax 408-562-5745
Mailing address
5201 Great America PkwySuite 320
Santa Clara, CA 95054-1122
Phone 408-730-6819 · Fax 408-562-5745
Authorized official
Paul O Momoh
President
4087306819
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