Provider Demographics
NPI:1427580109
Name:ONCOCYTE, CORPORATION
Entity Type:Organization
Organization Name:ONCOCYTE, CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ACCOUNTING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:KALAJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-755-0514
Mailing Address - Street 1:15 CUSHING
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-4220
Mailing Address - Country:US
Mailing Address - Phone:510-871-4195
Mailing Address - Fax:
Practice Address - Street 1:150 N HILL DR STE 14
Practice Address - Street 2:
Practice Address - City:BRISBANE
Practice Address - State:CA
Practice Address - Zip Code:94005-1023
Practice Address - Country:US
Practice Address - Phone:496-357-2579
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-31
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIN-PROCESS291U00000X
291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory