Provider Demographics
NPI:1588301493
Name:VERICI DX INC
Entity type:Organization
Organization Name:VERICI DX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CONNOLLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-373-4411
Mailing Address - Street 1:393 NICHOL MILL LN STE 200
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-8324
Mailing Address - Country:US
Mailing Address - Phone:833-243-4552
Mailing Address - Fax:629-235-4545
Practice Address - Street 1:393 NICHOL MILL LN STE 200
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-8324
Practice Address - Country:US
Practice Address - Phone:833-243-4552
Practice Address - Fax:629-235-4545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory