Organization
MITRA RXDX
Active
Other names
MitraBiotech
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW NOWLAND (SR. VP RA/QA)
(339) 999-2300
Entity
Organization
Contact information
Practice address
12 GILL ST STE 3150, WOBURN, MA 01801-1777
(339) 999-2300
(339) 999-2399
Mailing address
12 GILL ST STE 3150, WOBURN, MA 01801-1777
(339) 999-2300
(339) 999-2399
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NOT APPLICABLE
—
Enumeration date
09/20/2017
Last updated
07/21/2022
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