PRECISION TOXICOLOGY, LLC (NPI# 1043737505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043737505 |
| Entity Type | Organization |
| Organization Name | PRECISION TOXICOLOGY, LLC |
| Other Organization Name | PRECISION DIAGNOSTICS |
| Practice Address |
49 State Rd Ste 103n Dartmouth MA 02747-3303 |
| Mailing Address |
6755 Mira Mesa Blvd Ste 123-153 San Diego CA 92121-4392 |
| Practice Telephone | 8006356901 |
| Practice Fax Number | 8582289909 |
| Mailing Telephone | 8006356901 |
| Mailing Fax Number | 8582289909 |
| Enumeration Date | 2017-08-25 |
| Last Update Date | 2019-04-24 |
| Authorized Official Name | MR. MIGUEL GALLEGO (CEO) |
| Authorized Official Telephone | 8006356901 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | CLIA REGISTRATION | 22D2133197 | 01 |
| MA | CLINICAL LAB LICENSE | 5434 | 01 |
| MA | 110129278A | 05 |
| Other Name | Type Code |
|---|---|
| Precision Diagnostics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730466590 | Precision Toxicology, LLC | Clinical Medical Laboratory | 4215 Sorrento Valley Blvd, San Diego, CA 92121-1408 | 2011-11-08 |
| 1114319563 | Precision Toxicology, LLC | Clinical Medical Laboratory | 836 Farmington Ave, Suite 212, West Hartford, CT 06119-1505 | 2015-02-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PRECISION TOXICOLOGY, LLC | 4215 Sorrento Valley Blvd, San Diego, CA 92121-1408 |
| Colorado Business Entities | PRECISION TOXICOLOGY, LLC | 4215 Sorrento Valley Blvd, San Diego, CA 92121 |
| Iowa Business Entities | PRECISION TOXICOLOGY, LLC | 4215 Sorrento Valley Blvd, Ste 101, San Diego, CA 92121 |
| Vermont Business Registrations | PRECISION TOXICOLOGY, LLC | 3030 Bunker Hill Street, Suite 101, San Diego, CA 92109 |
| Oregon Corporations, Companies and Business Names | PRECISION TOXICOLOGY, LLC | 4215 Sorrento Valley Blvd, San Diego, CA 92121 |
| Connecticut Business Registrations | PRECISION TOXICOLOGY, LLC | 4215 Sorrento Valley Blvd, San Diego, CA 92121 |
| Massachusetts Corporations | PRECISION TOXICOLOGY, LLC | 3030 Bunker Hill St. Ste. 101, San Diego, CA 92109 |
| Indiana Business Entities | PRECISION TOXICOLOGY, LLC | 3030 Bunker Hill St, Suite 101, San Diego, CA 92109 |
| Street Address |
49 STATE RD STE 103N |
| City | DARTMOUTH |
| State | MA |
| Zip Code | 02747-3303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619432531 | Michelle Mulvey-sylvia | Nurse Practitioner | 237 State Road, Dartmouth, MA 02747 | 2019-02-05 |
| 1679078232 | Andrew Paul Macedo | Emergency Medical Technician, Basic | 80 Alpha Street, Dartmouth, MA 02747 | 2018-03-27 |
| 1255712378 | Courtney Mota Trevino | Optometrist | 83b Faunce Corner Rd, North Dartmouth, MA 02747 | 2015-06-15 |
| 1215323852 | Kara J. Kopaczewski | Family Medicine | 49 State Rd Pequot Bldg, Ste 204, North Dartmouth, MA 02747 | 2015-04-10 |
| 1427465368 | Glicksman-gomes, LLC | Dentist | 49 State Road Nauset Bldg., Dartmouth, MA 02747 | 2014-07-11 |
| 1033544846 | Blackstone Behavioral Health Services | Psychologist | 145k Faunce Corner Rd., North Dartmouth, MA 02747 | 2013-09-11 |
| 1477999894 | Christina Nicolau | Counselor | 145k Faunce Corner Road, North Dartmouth, MA 02747 | 2013-05-13 |
| 1770823882 | Wendy Stacy | Behavioral Analyst | 145 Fauce Corner Rd., N. Dartmouth, MA 02747 | 2013-02-26 |
| 1952653131 | Eye Health Associates Inc | Optometrist | 51 State Road, Dartmouth, MA 02747 | 2012-10-11 |
| 1265782866 | Helpful Hands, Inc | Home Health | 106a State Rd, N Dartmouth, MA 02747 | 2012-09-12 |
| Find all providers in zip 02747 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
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| 1528688041 | Orig3n, Inc. | Clinical Medical Laboratory | 27 Drydock Ave Ste 3, Boston, MA 02210-2382 | 2020-04-24 |
| 1215595608 | Karen Weeks | Clinical Medical Laboratory | 526 Main St, One Acton Pl, Suite 102, Acton, MA 01720 | 2019-05-31 |
| 1770047995 | Quest Diagnostics Massachusetts LLC | Clinical Medical Laboratory | 5 Neponset St Ste 1581, Worcester, MA 01606-2714 | 2019-01-23 |
| 1902390628 | Quest Diagnostics Massachusetts LLC | Clinical Medical Laboratory | 69 Camp St, Hyannis, MA 02601-3046 | 2018-06-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.