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General NPI Number Information
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NPI Number | 1366849200
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Entity Type | Organization
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Legal Business Name | QUANTIGEN LLC
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Dates
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Enumeration Date | 11/20/2014
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 10300 KINCAID DR STE 200
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City | FISHERS
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State | IN
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Zip | 46037-8509
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Country | US
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Telephone | 317-578-8980
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Fax | 317-578-8988
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Provider Business Mailing Address
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Address Line | 10300 KINCAID DR STE 200
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City | FISHERS
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State | IN
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Zip | 46037-8509
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Country | US
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Telephone | 317-578-8980
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Fax | 317-578-8988
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Authorized Official
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Title or Position | CEO
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Name | JAMES ELLIOTT
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Credential |
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Telephone | 317-385-4079
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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 | 15D2076283
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License Number State | IN
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