Organization
ADVAGENIX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM G KEARNS (PRESIDENT)
(301) 358-3564
Entity
Organization
Contact information
Practice address
9430 KEY WEST AVE, SUITE 130, ROCKVILLE, MD 20850-3324
(301) 358-3564
(240) 747-7300
Mailing address
9430 KEY WEST AVE, SUITE 130, ROCKVILLE, MD 20850-3324
(301) 358-3564
(240) 747-7300
Taxonomy
Speciality
Code
Description
License number
State
261QG0250X
Genetics Clinic/Center
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
09/30/2016
Last updated
04/02/2019
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