Organization
PACGENOMICS
Active
Other names
N/A
Organization subpart
No
Provider details
NPI number
Authorized official
KENT OLSAN (ADMINISTRATOR)
(281) 292-7411
Entity
Organization
Contact information
Practice address
28222 AGOURA RD, STE 200/2001, AGOURA HILLS, CA 91301-2411
(818) 597-1938
(818) 597-1939
Mailing address
1544 SAWDUST RD STE 280, SPRING, TX 77380-2986
(281) 292-7411
(281) 292-7481
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
08/04/2017
Last updated
05/26/2020
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