Organization
IMPACT GENETICS CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FRANCES LN JEWETT (PRESIDENT AND CEO)
(647) 478-4902
Entity
Organization
Contact information
Practice address
10880 WILSHIRE BLVD STE 1101, LOS ANGELES, CA 90024-4112
(647) 478-4902
(905) 697-9786
Mailing address
10880 WILSHIRE BLVD STE 1101, LOS ANGELES, CA 90024-4112
(647) 478-4902
(905) 697-9786
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
99D990947
ZZ
Other
Enumeration date
09/25/2014
Last updated
09/25/2014
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