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General NPI Number Information
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NPI Number | 1558170977
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Entity Type | Organization
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Legal Business Name | INNOTERIX LLC
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Dates
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Enumeration Date | 12/31/2024
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 900 WIND RIVER LN STE 106
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City | GAITHERSBURG
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State | MD
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Zip | 20878-1924
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Country | US
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Telephone | 561-724-7201
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Fax |
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Provider Business Mailing Address
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Address Line | 900 WIND RIVER LN STE 106
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City | GAITHERSBURG
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State | MD
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Zip | 20878-1924
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Country | US
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Telephone | 561-724-7201
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTIE DECOTIS
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Credential |
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Telephone | 561-724-7201
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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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