Healthcare Provider Details

I. General information

NPI: 1770973646
Provider Name (Legal Business Name): X-GENE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2015
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 LOVETON CIR STE 210
SPARKS GLENCOE MD
21152-9229
US

IV. Provider business mailing address

34 LOVETON CIR STE 210
SPARKS GLENCOE MD
21152-9229
US

V. Phone/Fax

Practice location:
  • Phone: 301-360-3537
  • Fax: 240-312-2097
Mailing address:
  • Phone: 301-360-3537
  • Fax: 240-312-2087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207ZP0007X
TaxonomyMolecular Genetic Pathology (Pathology) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: XIAO BING WANG
Title or Position: OWNER
Credential:
Phone: 443-520-8668