Provider Demographics
NPI:1578085551
Name:INVITRO GENETICS ARIZONA
Entity Type:Organization
Organization Name:INVITRO GENETICS ARIZONA
Other - Org Name:GENESIS GENETICS
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-601-9808
Mailing Address - Street 1:75 CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-1350
Mailing Address - Country:US
Mailing Address - Phone:203-601-5200
Mailing Address - Fax:
Practice Address - Street 1:437 S. 48TH STREET
Practice Address - Street 2:SUITE 106
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281
Practice Address - Country:US
Practice Address - Phone:602-218-8833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COOPERGENOMICS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-12
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory