Provider Demographics
NPI:1609938232
Name:GENETICS AND IVF INSTITUTE
Entity Type:Organization
Organization Name:GENETICS AND IVF INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:KOCHENDORFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-289-1963
Mailing Address - Street 1:3015 WILLIAMS DR STE 202
Mailing Address - Street 2:GIVF BUSINESS OFFICE
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4623
Mailing Address - Country:US
Mailing Address - Phone:703-289-1963
Mailing Address - Fax:703-698-3977
Practice Address - Street 1:3015 WILLIAMS DR STE 202
Practice Address - Street 2:GIVF BUSINESS OFFICE
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4623
Practice Address - Country:US
Practice Address - Phone:703-289-1963
Practice Address - Fax:703-698-3977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA291U00000X, 291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory