Provider Demographics
NPI:1841663358
Name:BIOCERNA, LLC
Entity type:Organization
Organization Name:BIOCERNA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-780-7169
Mailing Address - Street 1:8161 MAPLE LAWN BLVD
Mailing Address - Street 2:STE 375
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2538
Mailing Address - Country:US
Mailing Address - Phone:240-280-2144
Mailing Address - Fax:301-769-6659
Practice Address - Street 1:8161 MAPLE LAWN BLVD
Practice Address - Street 2:STE 375
Practice Address - City:FULTON
Practice Address - State:MD
Practice Address - Zip Code:20759-2538
Practice Address - Country:US
Practice Address - Phone:240-280-2144
Practice Address - Fax:301-769-6659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-05
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACOS 00800481291U00000X
FL800027363291U00000X
RILCO00788291U00000X
MD2007291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory