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NPI 1376337360

NPI 1376337360 : TRUGENE LABORATORY LLC : SUMMERVILLE, SC

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General NPI Number Information
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    NPI Number           |    1376337360
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    Entity Type          |    Organization 
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    Legal Business Name  |    TRUGENE LABORATORY LLC 
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Dates
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    Enumeration Date     |    04/07/2025
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    Last Update Date     |    04/07/2025
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Provider Practice Location Address
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    Address Line         |    1318 N MAIN ST # 1149 
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    City                 |    SUMMERVILLE
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    State                |    SC
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    Zip                  |    29483-7308
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    Country              |    US
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    Telephone            |    843-823-3363
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1318 N MAIN ST # 1149 
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    City                 |    SUMMERVILLE
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    State                |    SC
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    Zip                  |    29483-7308
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     MICHELLE  CAMPBELL 
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    Credential           |    
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    Telephone            |    843-823-3363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM2500X
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    Taxonomy Name        |    Medical Specialty Clinic/Center
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    License Number       |    
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    License Number State |    
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