Provider Demographics
NPI:1558093302
Name:BURNING ROCK DX LLC
Entity type:Organization
Organization Name:BURNING ROCK DX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF QUALITY
Authorized Official - Prefix:MR
Authorized Official - First Name:LAVEE
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-563-8063
Mailing Address - Street 1:121 INNOVATION DR STE 100
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92617-3092
Mailing Address - Country:US
Mailing Address - Phone:949-732-6488
Mailing Address - Fax:
Practice Address - Street 1:121 INNOVATION DR STE 100
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92617-3092
Practice Address - Country:US
Practice Address - Phone:949-732-6488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory MedicineGroup - Single Specialty