Provider Demographics
NPI:1326407636
Name:PACIFIC GENOMICS, LLC
Entity type:Organization
Organization Name:PACIFIC GENOMICS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:AUGUSTUS
Authorized Official - Last Name:LAMB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-352-1206
Mailing Address - Street 1:27 TECHNOLOGY DR
Mailing Address - Street 2:STE 100
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2364
Mailing Address - Country:US
Mailing Address - Phone:844-826-8274
Mailing Address - Fax:949-783-5302
Practice Address - Street 1:27 TECHNOLOGY DR
Practice Address - Street 2:STE 100
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2364
Practice Address - Country:US
Practice Address - Phone:844-826-8274
Practice Address - Fax:949-783-5302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-15
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory