Healthcare Provider Details

I. General information

NPI: 1578540845
Provider Name (Legal Business Name): ESOTERIX CLINICAL TRIALS SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 05/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 WALNUT AVE
CRANFORD NJ
07716-3372
US

IV. Provider business mailing address

PO BOX 2240
BURLINGTON NC
27216-2240
US

V. Phone/Fax

Practice location:
  • Phone: 908-709-5700
  • Fax:
Mailing address:
  • Phone: 800-222-7566
  • Fax: 336-436-1048

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. WILLIAM B HAYES
Title or Position: CFO EVP TREASURER
Credential:
Phone: 800-222-7566