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General NPI Number Information
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NPI Number | 1881130573
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Entity Type | Organization
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Legal Business Name | BIOGRAY, LLC
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Dates
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Enumeration Date | 01/18/2017
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Last Update Date | 10/09/2022
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Provider Practice Location Address
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Address Line | 5201 EDEN AVE STE 300
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City | EDINA
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State | MN
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Zip | 55436-2315
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Country | US
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Telephone | 952-988-2700
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Fax | 952-988-2701
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Provider Business Mailing Address
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Address Line | 5201 EDEN AVE STE 300
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City | EDINA
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State | MN
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Zip | 55436-2315
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Country | US
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Telephone | 952-988-2700
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Fax | 952-988-2701
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Authorized Official
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Title or Position | DIRECTOR
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Name | JOSHUA KNOBLOCH
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Credential |
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Telephone | 952-988-2700
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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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