Organization
PREDICTIVE BIOSCIENCES, INC.
Active
Organization
PREDICTIVE BIOSCIENCES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER KLEMM PH.D. (PRESIDENT & CHIEF EXECUTIVE OFFICER)
(781) 402-1780
Entity
Organization
Contact information
Practice address
128 SPRING ST, 400 LEVEL, B ANNEX, LEXINGTON, MA 02421-7848
(781) 402-1780
(781) 325-4939
Mailing address
128 SPRING ST, 400 LEVEL, B ANNEX, LEXINGTON, MA 02421-7848
(781) 402-1780
(781) 325-4939
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
2929
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22D1105541
CLIA ID
—
Enumeration date
05/26/2010
Last updated
08/20/2010
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