Organization
GENETICARE LABORATORY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBBIE LYNN CAMILLO (OWNER)
(618) 344-2920
Entity
Organization
Contact information
Practice address
2901 UNION RD, SUITE 250, SAINT LOUIS, MO 63125-3972
(314) 200-3109
(314) 200-3107
Mailing address
2901 UNION RD, SUITE 250, SAINT LOUIS, MO 63125-3972
(314) 200-3109
(314) 200-3107
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
26D2014386
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26D2014386
CLIA
MO
Enumeration date
01/12/2016
Last updated
01/12/2016
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