Provider Demographics
NPI:1114232006
Name:ARISTA MOLECULAR, INC.
Entity Type:Organization
Organization Name:ARISTA MOLECULAR, INC.
Other - Org Name:ALLIEDPATH, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VP, GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:E
Authorized Official - Last Name:MATCALF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-795-5121
Mailing Address - Street 1:2075 CORTE DEL NOGAL
Mailing Address - Street 2:SUITE G
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-1414
Mailing Address - Country:US
Mailing Address - Phone:877-554-5004
Mailing Address - Fax:858-408-3480
Practice Address - Street 1:2075 CORTE DEL NOGAL
Practice Address - Street 2:SUITE G
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-1414
Practice Address - Country:US
Practice Address - Phone:877-554-5004
Practice Address - Fax:858-408-3480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-16
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACLF338586291U00000X
291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory