Healthcare Provider Details

I. General information

NPI: 1962225896
Provider Name (Legal Business Name): INFINITE GENOMICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2024
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4850 NORTHSHORE LN
NORTH LITTLE ROCK AR
72118-5329
US

IV. Provider business mailing address

4850 NORTHSHORE LN
NORTH LITTLE ROCK AR
72118-5329
US

V. Phone/Fax

Practice location:
  • Phone: 501-798-7100
  • Fax: 501-798-7101
Mailing address:
  • Phone: 501-798-7100
  • Fax: 501-798-7101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: BRENT STAGGS
Title or Position: CEO
Credential:
Phone: 501-798-7100