Organization
CRISPER DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANIL SUWAL MD (CEO)
(616) 717-0331
Entity
Organization
Contact information
Practice address
5618 SHIELDS DR, BETHESDA, MD 20817-3532
(240) 200-9093
(240) 399-0236
Mailing address
5618 SHIELDS DR, BETHESDA, MD 20817-3532
(240) 200-9093
(240) 399-0236
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21D2203210
CLIA CERTIFICATE
MD
Enumeration date
01/13/2021
Last updated
01/13/2021
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