Provider Demographics
NPI:1245118330
Name:VIRGINIA POLYTECHNIC INSTITUTE AND STATE UNIVERSITY
Entity type:Organization
Organization Name:VIRGINIA POLYTECHNIC INSTITUTE AND STATE UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT AND CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:S
Authorized Official - Last Name:SEBRING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-231-7912
Mailing Address - Street 1:FRALIN BIOMEDICAL RESEARCH INSTITUTE AT VTC
Mailing Address - Street 2:4 RIVERSIDE CIRCLE, MOLECULAR DIAGNOSTICS LAB
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4950
Mailing Address - Country:US
Mailing Address - Phone:540-526-2630
Mailing Address - Fax:
Practice Address - Street 1:FRALIN BIOMEDICAL RESEARCH INSTITUTE AT VTC
Practice Address - Street 2:4 RIVERSIDE CIRCLE, MOLECULAR DIAGNOSTICS LAB
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4950
Practice Address - Country:US
Practice Address - Phone:540-526-2630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory