Organization
PERSONALIZED GENETICS LLC
Active
Other names
Personalized Genomics
Organization subpart
No
Provider details
NPI number
Authorized official
RAVITEJ B REDDY (CEO)
(412) 656-4941
Entity
Organization
Contact information
Practice address
607 COLLEGE AVE, PITTSBURGH, PA 15232-1700
(412) 361-6160
Mailing address
607 COLLEGE AVE, PITTSBURGH, PA 15232-1700
(412) 361-6160
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
39D2109711
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1032451710001
—
PA
Enumeration date
06/09/2016
Last updated
03/14/2019
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