Organization
ESOTERIX GENETIC LABORATORIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM B HAYES (CFO EVP TREASURER)
(800) 222-7566
Entity
Organization
Contact information
Practice address
4310 E COTTON CENTER BLVD STE 120, PHOENIX, AZ 85040-8857
(602) 254-6620
Mailing address
PO BOX 2240, BURLINGTON, NC 27216-2240
(800) 222-7566
(336) 436-1048
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03D0856238
CLIA
—
Enumeration date
11/16/2010
Last updated
08/15/2013
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