Organization
FERTILITY GENETICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATT TYSON (DIRECTOR, MANAGED CARE CONTRACTING)
(615) 477-6677
Entity
Organization
Contact information
Practice address
10290 RIDGEGATE CIR, LONE TREE, CO 80124-5331
(303) 788-8300
Mailing address
10290 RIDGEGATE CIR, LONE TREE, CO 80124-5331
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
—
—
261QG0250X
Genetics Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06D2107279
CLIA
—
Enumeration date
02/14/2024
Last updated
07/10/2026
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