Organization
CYTODX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE SHEA (MANAGER)
(781) 255-0555
Entity
Organization
Contact information
Practice address
200 CORPORATE PL, PEABODY, MA 01960-3840
(978) 535-1398
(781) 255-0594
Mailing address
200 CORPORATE PL, PEABODY, MA 01960-3840
(978) 535-1398
(781) 255-0594
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
2455
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0805971
—
MA
Enumeration date
03/10/2006
Last updated
08/22/2020
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