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General NPI Number Information
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NPI Number | 1578002861
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Entity Type | Organization
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Legal Business Name | GENE2GENOME, LLC
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Dates
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Enumeration Date | 02/20/2017
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 8659 BAYPINE RD SUITE 307, BUILDING 3
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City | JACKSONVILLE
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State | FL
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Zip | 32256
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Country | US
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Telephone | 904-322-7711
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Fax | 904-425-1515
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Provider Business Mailing Address
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Address Line | 8659 BAYPINE RD STE 307
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City | JACKSONVILLE
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State | FL
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Zip | 32256-7554
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Country | US
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Telephone | 904-322-7111
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Fax | 904-425-1515
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Authorized Official
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Title or Position | OWNER
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Name | ANNA SHIRAZI
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Credential |
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Telephone | 904-322-7711
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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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