Provider Demographics
NPI:1194110734
Name:ALLELE DIAGNOSTICS INC.
Entity type:Organization
Organization Name:ALLELE DIAGNOSTICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCELO
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-255-3532
Mailing Address - Street 1:120 N PINE ST STE 152
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-5030
Mailing Address - Country:US
Mailing Address - Phone:844-255-3532
Mailing Address - Fax:509-232-5779
Practice Address - Street 1:120 N PINE ST STE 152
Practice Address - Street 2:SUITE 202
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-5030
Practice Address - Country:US
Practice Address - Phone:844-255-3532
Practice Address - Fax:509-232-5779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-31
Last Update Date:2017-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA50D2086351291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory