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General NPI Number Information
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NPI Number | 1467845990
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Entity Type | Organization
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Legal Business Name | G6 GENOMICS, LLC
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Dates
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Enumeration Date | 03/09/2015
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Last Update Date | 03/09/2015
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Provider Practice Location Address
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Address Line | 189 DARLING AVE SUITE A-34
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106
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Country | US
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Telephone | 207-536-0194
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Fax |
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Provider Business Mailing Address
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Address Line | 317 GREAT BRIDGE BLVD STE B
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City | CHESAPEAKE
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State | VA
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Zip | 23320-7008
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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 | JAY JAMISON
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Credential |
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Telephone | 757-692-5858
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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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