Organization
PANGEA LABORATORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YAP CHEW (ADMINISTRATOR)
(949) 346-9393
Entity
Organization
Contact information
Practice address
14762 BENTLEY CIR, TUSTIN, CA 92780-7226
(949) 346-9393
Mailing address
14762 BENTLEY CIR, TUSTIN, CA 92780-7226
(493) 469-3939
(813) 642-4907
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D2120654
INDEPENDENT CLINICAL LABORATORY
—
Enumeration date
06/05/2020
Last updated
05/19/2023
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