Organization
GRANGER GENETICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH BOSTWICK M.B.A (OWNER)
(804) 915-3845
Entity
Organization
Contact information
Practice address
6784 LAKE ELLENOR DR, ORLANDO, FL 32809-4636
(804) 915-3845
(804) 648-2641
Mailing address
601 BIOTECH DR, SUITE 301, NORTH CHESTERFIELD, VA 23235-5167
(804) 915-3845
(804) 648-2641
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
800028179
FL
Other
Enumeration date
06/22/2016
Last updated
06/22/2016
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