Provider Demographics
NPI:1598158248
Name:CLARITAS GENOMICS , INC
Entity Type:Organization
Organization Name:CLARITAS GENOMICS , INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CORTIZAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-553-5805
Mailing Address - Street 1:99 ERIE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-4559
Mailing Address - Country:US
Mailing Address - Phone:617-553-5800
Mailing Address - Fax:617-553-5842
Practice Address - Street 1:99 ERIE ST
Practice Address - Street 2:SUITE A
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-4559
Practice Address - Country:US
Practice Address - Phone:617-553-5800
Practice Address - Fax:617-553-5842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA22D0950490OtherCLIA