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General NPI Number Information
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NPI Number | 1730482720
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Entity Type | Organization
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Legal Business Name | KAILOS GENETICS, LLC
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Dates
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Enumeration Date | 12/13/2010
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Last Update Date | 05/30/2023
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Provider Practice Location Address
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Address Line | 601 GENOME WAY SUITE 2005
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City | HUNTSVILLE
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State | AL
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Zip | 35806-2908
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Country | US
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Telephone | 256-327-9800
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Fax | 256-327-9810
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Provider Business Mailing Address
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Address Line | 601 GENOME WAY SUITE 2005
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City | HUNTSVILLE
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State | AL
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Zip | 35806-2908
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Country | US
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Telephone | 256-327-9800
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Fax | 256-327-9810
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Authorized Official
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Title or Position | CEO
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Name | MR. BRIAN KEITH POLLOCK
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Credential |
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Telephone | 256-327-9801
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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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