Provider Demographics
NPI:1497156236
Name:SERODYNAMICS, LLC
Entity Type:Organization
Organization Name:SERODYNAMICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER / PRESIDENT OF SALES
Authorized Official - Prefix:
Authorized Official - First Name:BEAU
Authorized Official - Middle Name:
Authorized Official - Last Name:GERTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-877-8789
Mailing Address - Street 1:4785 TEJON ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-1259
Mailing Address - Country:US
Mailing Address - Phone:303-990-5912
Mailing Address - Fax:855-928-0101
Practice Address - Street 1:4785 TEJON ST
Practice Address - Street 2:SUITE 101
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-1259
Practice Address - Country:US
Practice Address - Phone:303-990-5912
Practice Address - Fax:855-928-0101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-11
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO06D2082846291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory