Organization
ADVANCED GENETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID KU MD (MEDICAL DIRECTOR)
(305) 902-6990
Entity
Organization
Contact information
Practice address
3650 NW 82ND AVENUE, SUITE 307, MIAMI, FL 33166-6694
(305) 902-6990
(626) 507-3136
Mailing address
3650 NW 82ND AVENUE, SUITE 307, MIAMI, FL 33166-6694
(305) 902-6990
(626) 507-3136
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10F2200505
CLIA
FL
Enumeration date
11/27/2020
Last updated
11/27/2020
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