Provider Demographics
NPI:1831988047
Name:GENETDX INC
Entity type:Organization
Organization Name:GENETDX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GUITY
Authorized Official - Middle Name:
Authorized Official - Last Name:GHAFFARI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:352-871-1291
Mailing Address - Street 1:10748 NORTHBROOK CIR
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33412-7307
Mailing Address - Country:US
Mailing Address - Phone:352-871-1291
Mailing Address - Fax:
Practice Address - Street 1:747 SW 2ND AVE STE 227
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-6280
Practice Address - Country:US
Practice Address - Phone:352-871-1291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory