Provider Demographics
NPI:1437710415
Name:STAGEZERO LIFE SCIENCES INC
Entity Type:Organization
Organization Name:STAGEZERO LIFE SCIENCES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFONSO
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMARENA
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:530-237-7910
Mailing Address - Street 1:8751 PARK CENTRAL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-1162
Mailing Address - Country:US
Mailing Address - Phone:804-261-3340
Mailing Address - Fax:804-515-7291
Practice Address - Street 1:8751 PARK CENTRAL DR STE 200
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-1162
Practice Address - Country:US
Practice Address - Phone:804-261-3340
Practice Address - Fax:804-515-7291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-21
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory MedicineGroup - Single Specialty