Provider Demographics
NPI:1588938690
Name:20/20 GENESYSTEMS, INC.
Entity type:Organization
Organization Name:20/20 GENESYSTEMS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:VLADIMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:KNEZEVIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-453-6339
Mailing Address - Street 1:PO BOX 347888
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-4888
Mailing Address - Country:US
Mailing Address - Phone:240-453-6339
Mailing Address - Fax:240-403-0289
Practice Address - Street 1:9430 KEY WEST AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3324
Practice Address - Country:US
Practice Address - Phone:240-453-6339
Practice Address - Fax:240-403-0289
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:20/20 GENESYSTEMS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-07
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory