Organization
MOLECULARMD, CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAD GALDERISI D.O. (VICE PRESIDENT MEDICAL AFFAIRS)
(503) 442-2922
Entity
Organization
Contact information
Practice address
1341 SW CUSTER DR, PORTLAND, OR 97219-2750
(503) 442-2922
Mailing address
1341 SW CUSTER DR, PORTLAND, OR 97219-2750
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
38D1052238
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276220
—
OR
Enumeration date
03/20/2014
Last updated
03/20/2014
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