Provider Demographics
NPI:1811249238
Name:BIODESIX, INC.
Entity type:Organization
Organization Name:BIODESIX, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP LEGAL & REGULATORY AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:AUSTIN
Authorized Official - Last Name:BOJAR
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:303-417-0500
Mailing Address - Street 1:2970 WILDERNESS PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-5412
Mailing Address - Country:US
Mailing Address - Phone:303-417-0500
Mailing Address - Fax:303-417-9700
Practice Address - Street 1:10530 DISCOVERY DR
Practice Address - Street 2:#1931
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89135-3039
Practice Address - Country:US
Practice Address - Phone:720-214-7950
Practice Address - Fax:702-431-5122
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIODESIX, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV29D2044323291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory