Organization
TEST SAN DIEGO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER STELLERS (AUTHORIZED OFFICIAL)
(619) 494-0397
Entity
Organization
Contact information
Practice address
4080 CENTRE ST STE 107, SAN DIEGO, CA 92103-2655
(888) 738-8772
Mailing address
4080 CENTRE ST STE 107, SAN DIEGO, CA 92103-2655
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
08/24/2022
Last updated
08/24/2022
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