Provider Demographics
NPI:1528694627
Name:CLOVER GENETICS, LLC
Entity type:Organization
Organization Name:CLOVER GENETICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENETIC COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MCCARTY
Authorized Official - Suffix:
Authorized Official - Credentials:CGC
Authorized Official - Phone:610-316-3099
Mailing Address - Street 1:201 CHEYENNE DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-5203
Mailing Address - Country:US
Mailing Address - Phone:610-316-3099
Mailing Address - Fax:412-465-6050
Practice Address - Street 1:201 CHEYENNE DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-5203
Practice Address - Country:US
Practice Address - Phone:610-316-3099
Practice Address - Fax:412-465-6050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-20
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QG0250XAmbulatory Health Care FacilitiesClinic/CenterGenetics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1497139893OtherNPI TYPE 1