Organization
GENESIS REFERENCE LABORATORIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP DAVID FREITAS (MANAGING MEMBER)
(407) 232-7172
Entity
Organization
Contact information
Practice address
7924 FOREST CITY RD STE 210, ORLANDO, FL 32810-2925
(407) 232-7172
(407) 289-4082
Mailing address
7924 FOREST CITY RD STE 210, ORLANDO, FL 32810-2925
(407) 232-7172
(407) 289-4082
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
04/21/2015
Last updated
05/16/2019
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