Provider Demographics
NPI:1114346616
Name:G6 GENOMICS, LLC
Entity Type:Organization
Organization Name:G6 GENOMICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-692-5858
Mailing Address - Street 1:317 GREAT BRIDGE BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-7008
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1745 PHOENIX BLVD
Practice Address - Street 2:SUITE 335
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-5591
Practice Address - Country:US
Practice Address - Phone:844-725-7330
Practice Address - Fax:770-629-6907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-11
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory