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Organization

PRECISION TOXICOLOGY, LLC

Active
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Organization

PRECISION TOXICOLOGY, LLC

Active
Other names
Precision Diagnostics
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MIGUEL GALLEGO (CEO)
(800) 635-6901
Entity
Organization

Contact information

Practice address
4215 SORRENTO VALLEY BLVD STE 100, SAN DIEGO, CA 92121-1408
(800) 635-6901
(858) 228-9909
Mailing address
6755 MIRA MESA BLVD, STE 123-153, SAN DIEGO, CA 92121-4392
(800) 635-6901
(858) 228-9909

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05D2054760
CLIA ACCREDITATION
CA
05
1730466590
CA
01
800026849
FLORIDA CLINICAL LICENSE
FL
01
8719436
CAP
CA
01
HK270A
MEDICARE PTAN
CA
Enumeration date
11/08/2011
Last updated
06/03/2024
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