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 (VICE PRESIDENT)
(678) 477-4402
Entity
Organization
Contact information
Practice address
7 CHIANTI, LADERA RANCH, CA 92694-1402
(949) 426-4798
Mailing address
6655 N MACARTHUR BLVD, IRVING, TX 75039-2443
(346) 202-6091
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
09/01/2023
Last updated
09/01/2023
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