Organization
ADVANTA GENETICS LLC
Active
Other names
ADVANTA ANALYTICAL LABORATORIES, ADVANTA TOXICOLOGY LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES GUILBAULT (CEO)
(903) 805-9955
Entity
Organization
Contact information
Practice address
10935 COUNTY ROAD 159, TYLER, TX 75703-3333
(903) 805-9955
(903) 839-2494
Mailing address
10935 COUNTY ROAD 159, TYLER, TX 75703-3333
(903) 805-9955
(903) 839-2494
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45D2063134
CLIA NUMBER
TX
01
—
8863194
CAP
TX
Enumeration date
11/20/2013
Last updated
04/29/2026
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