Organization
ESOTERIX GENETIC LABORATORIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY WILLIAMS (VICE PRESIDENT)
(800) 222-7566
Entity
Organization
Contact information
Practice address
3 FOREST PKWY, SHELTON, CT 06484-6122
(336) 436-7942
Mailing address
PO BOX 2240, BURLINGTON, NC 27216-2240
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07D2141078
CLIA
—
Enumeration date
01/12/2018
Last updated
01/12/2018
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