RENEGADEXBIO, PBC (NPI# 1083237374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083237374 |
| Entity Type | Organization |
| Organization Name | RENEGADEXBIO, PBC |
| Other Organization Name | RENEGADE.BIO |
| Practice Address |
5700 Martin Luther King Jr Way # 1521 Oakland CA 94609-1673 |
| Mailing Address |
181 2nd St San Francisco CA 94105-3808 |
| Practice Telephone | 4153389306 |
| Practice Fax Number | 4153297843 |
| Mailing Telephone | 4153389306 |
| Mailing Fax Number | 4153297843 |
| Enumeration Date | 2020-05-21 |
| Last Update Date | 2020-06-11 |
| Authorized Official Name | CRAIG ROUSKEY (CEO) |
| Authorized Official Telephone | 4153389306 |
| Authorized Official Credential | MS |
| 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 |
|---|---|---|---|
| CLIA | 05D2185960 | 01 | |
| CA | STATE ID | CDF-90000924 | 01 |
| Other Name | Type Code |
|---|---|
| Renegade.Bio | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | RENEGADEXBIO, PBC | 181 2nd St, San Francisco, California 94105 |
| Street Address |
5700 MARTIN LUTHER KING JR WAY # 1521 |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-1673 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104457159 | Gerard John-charles Coughlin | Student in an Organized Health Care Education/Training Program | Samuel Merritt University, 3100 Telegraph Avenue, Oakland, CA 94609 | 2020-01-29 |
| 1417502022 | Michael Knittel | Registered Nurse | 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1962057562 | Nicole Kjolby | Registered Nurse | Samuel Merritt College, 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1396208286 | Graham Vallis | Student in an Organized Health Care Education/Training Program | Ucsf Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA 94609 | 2019-04-09 |
| 1386129526 | Gary Mitchell Snider | Counselor | 390 40th Street, Oakland, CA 94609 | 2018-10-02 |
| 1720568389 | Lice Control Inc. | Technician | 6557 Shattuck Ave, Oakland, CA 94609 | 2018-08-14 |
| 1528559150 | Jenna Marie Kincaid | Behavior Technician | 400 29th St., 204, Oakland, CA 94609 | 2018-05-18 |
| 1336656669 | Nicholas Dicarlo | Social Worker | 465 34th St Ste 6, Oakland, CA 94609 | 2018-01-09 |
| 1174045744 | Theodora J Marzouk | Home Health Aide | 3317 Elm Street, Suite 202, Oakland, CA 94609 | 2017-07-14 |
| 1740728922 | Elena Gardella | Marriage & Family Therapist | 411 30th Street, Suite 412, Oakland, CA 94609 | 2017-02-07 |
| Find all providers in zip 94609 | ||||
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629356688 | Family Planning Associates Medical Group, Inc. | Clinical Medical Laboratory | 400 29th St Ste 301, Oakland, CA 94609-3548 | 2011-07-25 |
| 1487876116 | Alameda County Public Health Laboratory | Clinical Medical Laboratory | 2901 Peralta Oaks Ct, Room 206, Oakland, CA 94605-5319 | 2007-05-03 |
| 1669539243 | Machaon Diagnostics, Inc. | Clinical Medical Laboratory | 3023 Summit St, Oakland, CA 94609-3412 | 2007-01-02 |
| 1144336181 | La Clinica De La Raza Inc | Clinical Medical Laboratory | 3451 E 12th St, Oakland, CA 94601-3425 | 2006-08-22 |
| 1295181477 | Sutter Bay Hospitals | Clinical Medical Laboratory | 350 Hawthorne Ave, Oakland, CA 94609-3108 | 2016-05-06 |
| 1053702894 | Garrett Medical Group, Pa | Clinical Medical Laboratory | 311 N 4th St, Oakland, MD 21550-1371 | 2015-02-16 |
| 1568694792 | Ahi Solutions, Inc. | Clinical Medical Laboratory | 400 29th St, #208, Oakland, CA 94609-3522 | 2009-08-21 |
| 1891907150 | Alfred J Reynaud | Clinical Medical Laboratory | 2929 Summit St, #208, Oakland, CA 94609 | 2007-05-07 |
| 1972671485 | United Physicianc Care Inc | Clinical Medical Laboratory | 1533 Memorial Dr, Oakland, MD 21550-4338 | 2006-12-01 |
| 1235245275 | La Clinica De La Raza Inc | Clinical Medical Laboratory | 1515 Fruitvale Ave, Oakland, CA 94601-2322 | 2006-08-22 |
| Find all providers in OAKLAND | ||||
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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.