Healthcare Provider Details

I. General information

NPI: 1346959970
Provider Name (Legal Business Name): PRECISION GENETICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2022
Last Update Date: 11/22/2022
Certification Date: 11/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 PATEWOOD DR STE 4173
GREENVILLE SC
29615-3593
US

IV. Provider business mailing address

430 ROPER MOUNTAIN RD STE B
GREENVILLE SC
29615-4243
US

V. Phone/Fax

Practice location:
  • Phone: 877-843-6544
  • Fax: 866-645-9526
Mailing address:
  • Phone: 877-843-6544
  • Fax: 866-645-9526

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: JEREMY STUART
Title or Position: CHIEF SCIENTIFIC OFFICER/CLIA DIR
Credential: PHD
Phone: 864-630-2225