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General NPI Number Information
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NPI Number | 1780308262
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Entity Type | Organization
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Legal Business Name | CIRCULOGENE THERANOSTICS, INC.
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Dates
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Enumeration Date | 09/28/2022
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 219 E GARDEN ST STE 300
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City | PENSACOLA
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State | FL
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Zip | 32502-4806
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Country | US
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Telephone | 855-614-7083
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Fax | 855-614-7084
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Provider Business Mailing Address
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Address Line | PO BOX 830525
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City | BIRMINGHAM
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State | AL
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Zip | 35283-0525
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Country | US
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Telephone | 855-614-7083
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Fax | 855-614-7084
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Authorized Official
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Title or Position | CEO
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Name | MR. MICHAEL V. MULLEN
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Credential |
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Telephone | 855-614-7083
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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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