Provider Demographics
NPI:1609468420
Name:TRUGENOMIX HEALTH INC.
Entity Type:Organization
Organization Name:TRUGENOMIX HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:NACLERIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-389-3554
Mailing Address - Street 1:9841 WASHINGTONIAN BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-7350
Mailing Address - Country:US
Mailing Address - Phone:808-389-3554
Mailing Address - Fax:
Practice Address - Street 1:11100 ENDEAVOR CT STE 119
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-4027
Practice Address - Country:US
Practice Address - Phone:808-389-3554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-04
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory