Organization
DRIVER INC.
Active
Other names
Driver Genomics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETROS GIANNIKOPOULOS M.D. (PRESIDENT)
(415) 660-7241
Entity
Organization
Contact information
Practice address
1700 OWENS ST, SUITE 405, SAN FRANCISCO, CA 94158-0002
(415) 660-7241
(415) 252-7599
Mailing address
1700 OWENS ST, SUITE 405, SAN FRANCISCO, CA 94158-0002
(415) 660-7241
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF00345026
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D2067056
CLIA NUMBER
—
01
—
CLF00345026
STATE OF CALIFORNIA CLINICAL LABORATORY LICENSE
CA
Enumeration date
04/14/2015
Last updated
05/02/2017
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