Provider Demographics
NPI:1811660327
Name:FIRST RATE LAB LLC
Entity type:Organization
Organization Name:FIRST RATE LAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:TRISTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LINGAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD, CLS, MT
Authorized Official - Phone:949-374-2683
Mailing Address - Street 1:3189 AIRWAY AVE STE CAND
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-4612
Mailing Address - Country:US
Mailing Address - Phone:657-439-4540
Mailing Address - Fax:657-900-2181
Practice Address - Street 1:3189 AIRWAY AVE STE CAND
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4612
Practice Address - Country:US
Practice Address - Phone:657-439-4540
Practice Address - Fax:657-900-2181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-29
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACLF-90004560Medicaid