Organization
PRG TECHNOLOGIES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AHSAN BASEER PHD., CLS (TECHNICAL CONSULTANT)
(714) 493-1224
Entity
Organization
Contact information
Practice address
1020 S ANAHEIM BLVD STE 106, ANAHEIM, CA 92805-5808
(714) 215-4354
(714) 215-4324
Mailing address
1020 S ANAHEIM BLVD STE 106, ANAHEIM, CA 92805-5808
(714) 215-4354
(714) 215-4324
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D2193318
CLIA CERTIFICATE
CA
01
—
CDF-90001611
STATE OF CALIFORNIA LABORATORY LICENSE
CA
Enumeration date
09/21/2021
Last updated
08/09/2022
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