Provider Demographics
NPI:1154051977
Name:DNA MOLECULAR SCIENCES LLC
Entity Type:Organization
Organization Name:DNA MOLECULAR SCIENCES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP BUSINESS AND LABORATORY SVCS
Authorized Official - Prefix:MR
Authorized Official - First Name:ELIAS
Authorized Official - Middle Name:
Authorized Official - Last Name:VELERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-550-0124
Mailing Address - Street 1:9910 W CHEYENNE AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7708
Mailing Address - Country:US
Mailing Address - Phone:702-550-0124
Mailing Address - Fax:702-675-8122
Practice Address - Street 1:1400 REYNOLDS AVE STE 201
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-5563
Practice Address - Country:US
Practice Address - Phone:702-550-0124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory