Provider Demographics
NPI:1902464134
Name:GENETICS INSTITUTE OF AMERICA LABORATORY CORP
Entity Type:Organization
Organization Name:GENETICS INSTITUTE OF AMERICA LABORATORY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGLIOCHETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-590-3193
Mailing Address - Street 1:4733 W ATLANTIC AVE STE 12C
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-3890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1980 POST OAK BLVD STE 2020
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-3820
Practice Address - Country:US
Practice Address - Phone:978-590-3193
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory