Provider Demographics
NPI:1760875405
Name:AIBIO TECH LLC
Entity Type:Organization
Organization Name:AIBIO TECH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:BOSTWICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD MBA
Authorized Official - Phone:804-915-3845
Mailing Address - Street 1:601 BIOTECH DR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-5167
Mailing Address - Country:US
Mailing Address - Phone:804-915-3845
Mailing Address - Fax:804-648-2641
Practice Address - Street 1:601 BIOTECH DR
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-5167
Practice Address - Country:US
Practice Address - Phone:804-915-3845
Practice Address - Fax:804-648-2641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-05
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory