LABORATORY FOR PERSONALIZED MOLECULAR MEDICINE
Medical Laboratory at Nancy Ridge Dr, San Diego, CA

License number
California CLF 336024
Category
Medical Laboratory
Type
Clinical Medical Laboratory
Owner
Name: DR. JEFFREY E MILLER PHD
Title: PRESIDENT/CEO
Phone: (858) 623-8105
Address
Address
6330 Nancy Ridge Dr SUITE 106, San Diego, CA 92121
National Provider ID: 1184874703
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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LABORATORY FOR PERSONALIZED MOLECULAR MEDICINE, LLC

6330 Nancy Rdg Dr SUITE 106, San Diego, CA 92121

Status:
Inactive
Industry:
Clinical Reference Laboratory, Health/Allied Services
Inactive reason:
REINSTATEMENT
Registration:
May 2, 2013
Inactive since:
Mar 31, 2015
State ID:
M13000002813
Business type:
Foreign Limited Liability Company
Managers:
Jeffrey E Miller (Member), 6330 Nancy Rdg Dr SUITE 106, San Diego, CA 92121 (Physical),Isaacs, James B, Jr, 6330 Nancy Rdg Dr SUITE 106, San Diego, CA 92121 (Physical),Gary Clause Manager, inactive, 6330 Nancy Rdg Dr SUITE 106, San Diego, CA 92121 (Physical),...
Agent:
Northwest Registered Agent, Llc,3030 N Rocky Pt Dr STE 150A, Tampa, FL 33607 (Physical)
EIN:
300422446

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