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General NPI Number Information
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NPI Number | 1073591822
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Entity Type | Organization
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Legal Business Name | GENOVA DIAGNOSTICS INC
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Dates
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Enumeration Date | 01/03/2006
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Last Update Date | 05/10/2019
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Provider Practice Location Address
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Address Line | 63 ZILLICOA ST
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City | ASHEVILLE
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State | NC
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Zip | 28801-1038
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Country | US
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Telephone | 828-210-7321
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Fax | 828-210-7321
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Provider Business Mailing Address
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Address Line | 63 ZILLICOA ST
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City | ASHEVILLE
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State | NC
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Zip | 28801-1038
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Country | US
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Telephone | 888-540-2199
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Fax | 828-210-7321
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | MR. JEFFREY WILLIAM LEDFORD
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Credential |
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Telephone | 828-210-7764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 34D0655571
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License Number State | NC
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