Organization
CSI GENETICS, LLC
Active
Other names
CSI Genetics, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RON H. GHAFARY (OWNER)
(678) 205-4346
Entity
Organization
Contact information
Practice address
11525 PARK WOODS CIR, ALPHARETTA, GA 30005-4482
(678) 205-4346
(678) 205-4347
Mailing address
11525 PARK WOODS CIR, ALPHARETTA, GA 30005-4482
(678) 205-4346
(678) 205-4347
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
060-327
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1458431
—
LA
05
—
36203900
—
WI
Enumeration date
11/10/2006
Last updated
08/22/2020
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