Provider Demographics
NPI:1699774109
Name:THE CENTER FOR CYTOGENETICS, INC
Entity type:Organization
Organization Name:THE CENTER FOR CYTOGENETICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:BS, CLSUP
Authorized Official - Phone:615-321-2777
Mailing Address - Street 1:1719 W END AVE
Mailing Address - Street 2:SUITE 403E
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-5120
Mailing Address - Country:US
Mailing Address - Phone:615-321-2777
Mailing Address - Fax:
Practice Address - Street 1:1719 W END AVE
Practice Address - Street 2:SUITE 403E
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-5120
Practice Address - Country:US
Practice Address - Phone:615-321-2777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4061291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3404289Medicare ID - Type Unspecified