Organization
PMDLAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER SIMMONS (AUTHORIZED OFFICIAL)
(781) 626-1212
Entity
Organization
Contact information
Practice address
4630 NORTHGATE BLVD STE 150, SACRAMENTO, CA 95834-1141
(916) 776-8240
(916) 597-1379
Mailing address
3440 N 16TH ST STE 200, PHOENIX, AZ 85016-7125
(781) 626-1212
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF 11680
CA
Other
Enumeration date
04/17/2017
Last updated
05/06/2021
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