Healthcare Provider Details

I. General information

NPI: 1598117186
Provider Name (Legal Business Name): CLARITY GENETICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2016
Last Update Date: 07/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5231 NW 33RD AVE
FT LAUDERDALE FL
33309-6302
US

IV. Provider business mailing address

801 BROADWAY AVE NW STE 203
GRAND RAPIDS MI
49504-4463
US

V. Phone/Fax

Practice location:
  • Phone: 855-776-9436
  • Fax:
Mailing address:
  • Phone: 855-776-9436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. ALAN MACK
Title or Position: PRESIDENT
Credential:
Phone: 855-776-9436