Organization
PROGENE INC
Active
Other names
University Childrens Genetics Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
TUAN NGOC TRAN (PRESIDENT CEO)
(818) 548-0999
Entity
Organization
Contact information
Practice address
116 EAST BROADWAY, GLENDALE, CA 91205
(818) 548-0999
(818) 548-1555
Mailing address
116 EAST BROADWAY, GLENDALE, CA 91205
(818) 548-0999
(818) 548-1555
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CCF11452
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6915201
CAP
—
Enumeration date
04/30/2007
Last updated
08/22/2020
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