Provider Demographics
NPI:1336512391
Name:UNIVERSITY OF ARIZONA
Entity Type:Organization
Organization Name:UNIVERSITY OF ARIZONA
Other - Org Name:UNIVERSITY OF ARIZONA GENETICS CORE
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL LABORATORY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:MSC, PHD
Authorized Official - Phone:520-626-3645
Mailing Address - Street 1:1657 E HELEN ST RM 111L
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85721-0240
Mailing Address - Country:US
Mailing Address - Phone:520-621-4065
Mailing Address - Fax:
Practice Address - Street 1:1657 E HELEN ST RM 111L
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85721-0240
Practice Address - Country:US
Practice Address - Phone:520-621-4065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF ARIZONA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-12
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory