Organization
GENETIC IQ SOLUTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHACCASE DENISE JAMES (DIRECTOR/OWNER)
(985) 685-0125
Entity
Organization
Contact information
Practice address
15487 OAK LN STE D-E, GULFPORT, MS 39503-2664
(985) 685-0125
Mailing address
15487 OAK LN STE D-E, GULFPORT, MS 39503-2664
(985) 685-0125
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
08/28/2024
Last updated
08/28/2024
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