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General NPI Number Information
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NPI Number | 1114772902
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Entity Type | Organization
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Legal Business Name | REVEAL GENOMICS USA INC.
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Dates
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Enumeration Date | 04/23/2024
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Last Update Date | 04/23/2024
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Provider Practice Location Address
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Address Line | 150 N RESEARCH CAMPUS DR. OFFICE 4320, SUITE 4314
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City | KANNAPOLIS
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State | NC
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Zip | 28081
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Country | US
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Telephone | 704-250-2690
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Fax | 212-947-6246
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Provider Business Mailing Address
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Address Line | 150 N RESEARCH CAMPUS DR. OFFICE 4320, SUITE 4314
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City | KANNAPOLIS
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State | NC
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Zip | 28081
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Country | US
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Telephone | 704-250-2690
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Fax | 212-947-6246
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Authorized Official
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Title or Position | VICE PRESIDENT, MARKET ACCESS
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Name | MR. WESLEY HUNTER BUCKINGHAM
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Credential | BSC
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Telephone | 773-569-0628
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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 |
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License Number State |
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