Organization
AGATHOS LABORATORIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL O MOMOH PH.D. (PRESIDENT)
(408) 730-6819
Entity
Organization
Contact information
Practice address
5201 GREAT AMERICA PKWY, SUITE 320, SANTA CLARA, CA 95054-1122
(408) 730-6819
(408) 562-5745
Mailing address
5201 GREAT AMERICA PKWY, SUITE 320, SANTA CLARA, CA 95054-1122
(408) 730-6819
(408) 562-5745
Taxonomy
Speciality
Code
Description
License number
State
291900000X
Military Clinical Medical Laboratory
GH102230817
CA
291U00000X
Clinical Medical Laboratory
Primary
—
—
305S00000X
Point of Service
GH102230817
CA
332B00000X
Durable Medical Equipment & Medical Supplies
GH102230817
CA
Other
Enumeration date
11/04/2012
Last updated
01/21/2014
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