Organization
X-GENE MOLECULAR LABORATORIES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMIA FISHER (CREDENTIAL-CONTRACT ANALYST)
(812) 962-7894
Entity
Organization
Contact information
Practice address
4205 SPRINGHURST BLVD STE 101A, LOUISVILLE, KY 40241-6159
(859) 361-8704
Mailing address
7145 E VIRGINIA ST STE 2000, EVANSVILLE, IN 47715-9147
(812) 962-7894
Taxonomy
Speciality
Code
Description
License number
State
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18D2157664
CLIA
KY
01
—
200396
MEDICAL LABORATORY LICENSE
KY
Enumeration date
11/07/2018
Last updated
02/17/2022
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