Provider Demographics
NPI:1033566146
Name:ROSETTA GENOMICS INC
Entity Type:Organization
Organization Name:ROSETTA GENOMICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QUALITY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-587-7514
Mailing Address - Street 1:3711 MARKET ST
Mailing Address - Street 2:SUITE 740
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5504
Mailing Address - Country:US
Mailing Address - Phone:520-400-9936
Mailing Address - Fax:520-546-0674
Practice Address - Street 1:7840 E WHILEAWAY PL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85750-7409
Practice Address - Country:US
Practice Address - Phone:520-400-9936
Practice Address - Fax:520-546-0674
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROSETTA GENOMICS INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-18
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZCLIA 03D2112577291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory