Organization
LIFECELL DX, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANI BURKMAN PH.D. (FOUNDER / CHIEF SCIENCE OFFICER)
(716) 408-3306
Entity
Organization
Contact information
Practice address
4455 GENESEE ST, SUITE 25, BUFFALO, NY 14225-1928
(716) 408-3306
(716) 608-1322
Mailing address
4455 GENESEE ST, SUITE 25, BUFFALO, NY 14225-1928
(716) 408-3306
(716) 608-1322
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
PFI # 8376
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
# 33D 1088623
CLIA
NY
01
—
PFI # 8376
NEW YORK STATE DEPARTMENT OF HEALTH
NY
Enumeration date
12/07/2009
Last updated
12/07/2009
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