Organization
ESOTERIX GENETIC LABORATORIES, LLC
Active
Organization
ESOTERIX GENETIC LABORATORIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY T WILLIAMS (VICE PRESIDENT)
(336) 436-5761
Entity
Organization
Contact information
Practice address
5607 W CAVEDALE DR, PHOENIX, AZ 85083-6374
(480) 908-3992
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
—
03D2257935
CLIA
—
Enumeration date
08/16/2022
Last updated
08/16/2022
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