Organization
AV PRIME LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS MAGNO LOMIBAO CLS MTA 33999 CALIF (CLIN LABORATORY SCIENTIST MANAGER)
(661) 947-1288
Entity
Organization
Contact information
Practice address
1220 EAST AVENUE S, SUITE L, PALMDALE, CA 93550
(661) 947-1288
(661) 947-1844
Mailing address
1220 EAST AVENUE S, SUITE L, PALMDALE, CA 93550
(661) 947-1288
(661) 947-1844
Taxonomy
Speciality
Code
Description
License number
State
246Q00000X
Pathology Specialist/Technologist
Primary
—
CA
Other
Enumeration date
03/23/2007
Last updated
08/22/2020
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