Provider Demographics
NPI:1497239230
Name:GENALYTE, INC
Entity Type:Organization
Organization Name:GENALYTE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANACE
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RUTTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-215-1589
Mailing Address - Street 1:6620 MESA RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-3917
Mailing Address - Country:US
Mailing Address - Phone:858-956-1200
Mailing Address - Fax:858-939-1468
Practice Address - Street 1:7616 CULEBRA RD STE 130
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-1476
Practice Address - Country:US
Practice Address - Phone:726-201-3660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-18
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory