Provider Demographics
NPI:1154855690
Name:NAVICAN GENOMICS INC.
Entity Type:Organization
Organization Name:NAVICAN GENOMICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LUKAS
Authorized Official - Middle Name:
Authorized Official - Last Name:PIETER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-441-7277
Mailing Address - Street 1:341 S MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84111-3463
Mailing Address - Country:US
Mailing Address - Phone:801-441-7277
Mailing Address - Fax:
Practice Address - Street 1:341 S MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-3463
Practice Address - Country:US
Practice Address - Phone:801-441-7277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-11
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory