Organization
LUCID GENETICS, CORP.
Active
Other names
Lucid Genetics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEIGH JENNINGS MACK MD, PHD (PRESIDENT)
(727) 249-8241
Entity
Organization
Contact information
Practice address
970 LAKE CARILLON DR STE 300, ST PETERSBURG, FL 33716-1130
(727) 249-8241
Mailing address
970 LAKE CARILLON DR STE 300, ST PETERSBURG, FL 33716-1130
(727) 249-8241
Taxonomy
Speciality
Code
Description
License number
State
261QG0250X
Genetics Clinic/Center
Primary
—
—
Other
Enumeration date
01/29/2018
Last updated
01/29/2018
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