Provider Demographics
NPI:1396350112
Name:GRAIL, LLC
Entity type:Organization
Organization Name:GRAIL, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL COUNSEL AND CORP SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-694-2553
Mailing Address - Street 1:1525 O'BRIEN DRIVE
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025
Mailing Address - Country:US
Mailing Address - Phone:833-694-2553
Mailing Address - Fax:650-999-9000
Practice Address - Street 1:1525 O'BRIEN DRIVE
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025
Practice Address - Country:US
Practice Address - Phone:833-694-2553
Practice Address - Fax:650-999-9000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-09
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory