Organization
AMBRY GENETICS CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL RAYMOND MARTINSON (CFO)
(949) 900-5585
Entity
Organization
Contact information
Practice address
7 ARGONAUT, ALISO VIEJO, CA 92656-1423
(949) 900-5500
(949) 900-5501
Mailing address
1 ENTERPRISE, ALISO VIEJO, CA 92656-2606
(949) 457-4143
(949) 900-5501
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
CLF11694
CA
291U00000X
Clinical Medical Laboratory
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003151337A
—
GA
05
—
0054976
—
NJ
05
—
010127904
—
VA
05
—
0421379
—
MT
05
—
10025004600
—
NE
05
—
1006834
—
AK
05
—
1017246
—
VT
05
—
1024063580001
—
PA
05
—
1061577
—
WA
05
—
1464660
—
LA
05
—
1517245
—
TN
05
—
15197
—
ND
05
—
157113709
—
AR
05
—
200034590A
—
OK
05
—
200267720A
—
KS
05
—
200967250A
—
IN
05
—
212446301
—
TX
05
—
212446302
—
TX
05
—
2418146
—
OH
05
—
2958381
—
NY
05
—
419149800
—
MD
05
—
453277016
—
MI
05
—
462462900
—
MN
05
—
690000008
—
AL
05
—
69584834
—
CO
05
—
7100029600
—
KY
01
—
7154701
LAP CAP
CA
05
—
775960
—
MS
05
—
797178
—
AZ
05
—
806650800
—
ID
05
—
86759825
—
NM
05
—
9880101-000
—
WV
05
—
L00282
—
SC
05
—
LAB81414F
—
CA
Enumeration date
11/24/2006
Last updated
08/22/2024
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