Provider Demographics
NPI:1851748131
Name:ROSETTA GENOMICS INC.
Entity Type:Organization
Organization Name:ROSETTA GENOMICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QUALITY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCKEY
Authorized Official - Suffix:
Authorized Official - Credentials:CLS
Authorized Official - Phone:949-587-7514
Mailing Address - Street 1:3711 MARKET ST
Mailing Address - Street 2:SUITE 740
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5504
Mailing Address - Country:US
Mailing Address - Phone:501-353-0014
Mailing Address - Fax:855-373-2493
Practice Address - Street 1:10912 COLONEL GLENN RD
Practice Address - Street 2:SUITE 500
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-8010
Practice Address - Country:US
Practice Address - Phone:501-353-0014
Practice Address - Fax:855-373-2943
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROSETTA GENOMICS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARCLIA 04D2112060291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory