MEDICARE: PRECISION GENOMICS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1407718430
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECISION GENOMICS LLC

Provider Business Mailing Address
First Line	:	1100 STATE BLVD
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37064-8614
Country	:	US
Telephone Number	:	615-556-6628
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 STATE BLVD
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37064-8614
Country	:	US
Telephone Number	:	615-556-6628
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. RACHEL WISEMAN
Credential	:
Telephone Number	:	615-727-2412

Provider Enumeration Date	:	11/28/2025
Last Update Date	:	02/12/2026

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Directions to “PRECISION GENOMICS LLC ” Practice Location

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