Organization
PRIME DIAGNOSTICS LABORATORIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSE BRAGASIN (OWNER)
(661) 253-1173
Entity
Organization
Contact information
Practice address
27825 FREMONT CT, #14, VALENCIA, CA 91355-0989
(661) 253-1173
(661) 253-1174
Mailing address
72825 FREMONT CT.,, # 14, VALENCIA, CA 91355-1143
(661) 253-1173
(661) 253-1174
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
05D1019911
CA
Other
Enumeration date
08/30/2006
Last updated
06/03/2011
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