Healthcare Provider Details

I. General information

NPI: 1699774109
Provider Name (Legal Business Name): THE CENTER FOR CYTOGENETICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1719 W END AVE SUITE 403E
NASHVILLE TN
37203-5120
US

IV. Provider business mailing address

1719 W END AVE SUITE 403E
NASHVILLE TN
37203-5120
US

V. Phone/Fax

Practice location:
  • Phone: 615-321-2777
  • Fax:
Mailing address:
  • Phone: 615-321-2777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number4061
License Number StateTN

VIII. Authorized Official

Name: MR. GEORGE A ALLEN
Title or Position: SUPERVISOR
Credential: B.S., CLSUP
Phone: 615-321-2777