Provider Demographics
NPI:1376283317
Name:GENZEVA
Entity Type:Organization
Organization Name:GENZEVA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KEARNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-599-3220
Mailing Address - Street 1:9420 KEY WEST AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6379
Mailing Address - Country:US
Mailing Address - Phone:240-599-3200
Mailing Address - Fax:
Practice Address - Street 1:9430 KEY WEST AVE STE 130
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6399
Practice Address - Country:US
Practice Address - Phone:240-599-3200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-29
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No261QG0250XAmbulatory Health Care FacilitiesClinic/CenterGenetics