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General NPI Number Information
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NPI Number | 1861568784
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Entity Type | Organization
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Legal Business Name | AMBRY GENETICS CORPORATION
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Dates
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Enumeration Date | 11/24/2006
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Last Update Date | 08/22/2024
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Provider Practice Location Address
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Address Line | 7 ARGONAUT
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City | ALISO VIEJO
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State | CA
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Zip | 92656-1423
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Country | US
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Telephone | 949-900-5500
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Fax | 949-900-5501
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Provider Business Mailing Address
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Address Line | 1 ENTERPRISE
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City | ALISO VIEJO
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State | CA
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Zip | 92656-2606
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Country | US
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Telephone | 949-457-4143
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Fax | 949-900-5501
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Authorized Official
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Title or Position | CFO
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Name | MICHAEL RAYMOND MARTINSON
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Credential |
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Telephone | 949-900-5585
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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 | CLF11694
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License Number State | CA
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Taxonomy #2
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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 | CA
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