Provider Demographics
NPI:1518541325
Name:LIGHTSPEED TESTING LLC
Entity Type:Organization
Organization Name:LIGHTSPEED TESTING LLC
Other - Org Name:LIGHTSPEED TESTING
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMEER
Authorized Official - Middle Name:RAJNIKANT
Authorized Official - Last Name:BAKHDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:831-593-4800
Mailing Address - Street 1:530 DRY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4204
Mailing Address - Country:US
Mailing Address - Phone:831-583-7863
Mailing Address - Fax:
Practice Address - Street 1:530 DRY CREEK ROAD
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940
Practice Address - Country:US
Practice Address - Phone:760-214-2663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-07
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory