Provider Demographics
NPI:1255804092
Name:SEQUENTIAL GENETICS LLC
Entity type:Organization
Organization Name:SEQUENTIAL GENETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:TWINING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-273-1220
Mailing Address - Street 1:12105 28TH ST N STE A
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-1817
Mailing Address - Country:US
Mailing Address - Phone:727-273-1220
Mailing Address - Fax:727-575-7185
Practice Address - Street 1:12105 28TH ST N STE A
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-1817
Practice Address - Country:US
Practice Address - Phone:727-273-1220
Practice Address - Fax:727-575-7185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-04
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No261QG0250XAmbulatory Health Care FacilitiesClinic/CenterGenetics