Provider Demographics
NPI:1710750211
Name:GENTOX CLINICAL SOLUTION INC
Entity Type:Organization
Organization Name:GENTOX CLINICAL SOLUTION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUE
Authorized Official - Middle Name:D
Authorized Official - Last Name:KINCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-928-7939
Mailing Address - Street 1:296 SUMMERHILL RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SPOTSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08884-1245
Mailing Address - Country:US
Mailing Address - Phone:732-245-6270
Mailing Address - Fax:
Practice Address - Street 1:296 SUMMERHILL RD STE 102
Practice Address - Street 2:
Practice Address - City:SPOTSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08884-1245
Practice Address - Country:US
Practice Address - Phone:732-245-6270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory