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Organization
INFORM DIAGNOSTICS, INC.
Active
Organization
INFORM DIAGNOSTICS, INC.
Active
Parent organization
INFORM DIAGNOSTICS, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
INFORM DIAGNOSTICS, INC.
Authorized official
RAYMOND CHRISTOPHER WICKER (VP, GENERAL MANAGER)
(678) 477-4402
Entity
Organization
Contact information
Practice address
827 GROVE VIEW RD, OCEANSIDE, CA 92057-2202
(888) 290-5307
Mailing address
1111 S FREEPORT PKWY, COPPELL, TX 75019-4435
(888) 290-5307
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
NULL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
NULL
Other
Enumeration date
02/17/2025
Last updated
02/17/2025
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