Organization
SYMBIOTICA
Active
Organization
SYMBIOTICA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA HONGO (CO-CEO)
(916) 296-5666
Entity
Organization
Contact information
Practice address
1350 BURTON DR STE 210, VACAVILLE, CA 95687-3542
(818) 808-9192
Mailing address
1350 BURTON DR STE 210, VACAVILLE, CA 95687-3542
(818) 808-9192
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D2181231
CLIA
CA
01
—
CLF-90000561
CA-DOH CLINICAL LABORATORY
CA
Enumeration date
08/12/2020
Last updated
08/12/2020
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