Organization
ESOTERIX GENETIC LABORATORIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY T WILLIAMS (VICE PRESIDENT)
(800) 222-7566
Entity
Organization
Contact information
Practice address
3400 COMPUTER DR, WESTBOROUGH, MA 01581-1771
(508) 898-9001
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
—
22D0650245
CLIA
—
Enumeration date
11/17/2010
Last updated
08/13/2019
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