# INFORM DIAGNOSTICS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** INFORM DIAGNOSTICS, INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1760287445
- **Legal business name:** INFORM DIAGNOSTICS, INC.
- **Authorized official:** RAYMOND CHRISTOPHER WICKER (VP, GENERAL MANAGER)
- **Authorized official phone:** (678) 477-4402

## Contact information

- **Practice address:** 10393 PARKSIDE DR, BRECKSVILLE, OH 44141-3802
- **Practice address phone:** (888) 290-5307
- **Mailing address:** 1111 S FREEPORT PKWY, COPPELL, TX 75019-4435
- **Mailing address phone:** (888) 290-5307

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207NI0002X | Clinical & Laboratory Dermatological Immunology Physician | — | NULL | Yes |
| 207NI0002X | Clinical & Laboratory Dermatological Immunology Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/17/2025
- **Last updated:** 02/17/2025