Molecular Matrix, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MOLECULAR MATRIX, INC.

Practice address

11121 Sun Center Dr Ste J
Rancho Cordova, CA 95670-6199

Phone

(916) 376-9404

NPI assigned

Sep 25, 2020

Last updated

Dec 5, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charles Lee

Title

Ceo

Phone

(530) 400-2169

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670198400000",
    "number": "1922615756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11121 SUN CENTER DR STE C",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956706199",
            "telephone_number": "916-376-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11121 SUN CENTER DR STE J",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956706199",
            "telephone_number": "916-376-9404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLECULAR MATRIX, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-25",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "530-400-2169"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Angelo Tique Miraflor
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• Ann Miyamura, O.D.
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• Mokbil Dental Corporation (Rancho Cordova Smiles Dentistry Dental Group)
• Maria Moncrief, NP
• Marissa G Montelongo, MSW
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• Coralisha K Moore
• Lady D Moore

• Clinical Medical Laboratory in Rancho Cordova, CA
• Providers in Rancho Cordova, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.