Organization
ESOTERIX GENETIC LABORATORIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY T WILLIAMS (VICE PRESIDENT)
(336) 436-5402
Entity
Organization
Contact information
Practice address
50 BRIDGE ST APT 211, SHELTON, CT 06484-3503
(509) 842-2720
Mailing address
PO BOX 2270, BURLINGTON, NC 27216-2270
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07D2272128
CLIA
—
Enumeration date
02/16/2023
Last updated
02/16/2023
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