Provider Demographics
NPI: | 1144465295 |
---|---|
Name: | BIODESIX, INC. |
Entity type: | Organization |
Organization Name: | BIODESIX, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | VP, LEGAL & REGULATORY AFFAIRS |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | JEFFREY |
Authorized Official - Middle Name: | AUSTIN |
Authorized Official - Last Name: | BOJAR |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | JD |
Authorized Official - Phone: | 303-417-0500 |
Mailing Address - Street 1: | 2970 WILDERNESS PL |
Mailing Address - Street 2: | SUITE 100 |
Mailing Address - City: | BOULDER |
Mailing Address - State: | CO |
Mailing Address - Zip Code: | 80301-5412 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 303-417-0500 |
Mailing Address - Fax: | 303-417-9700 |
Practice Address - Street 1: | 12635 E MONTVIEW BLVD |
Practice Address - Street 2: | SUITE 211 |
Practice Address - City: | AURORA |
Practice Address - State: | CO |
Practice Address - Zip Code: | 80045-7335 |
Practice Address - Country: | US |
Practice Address - Phone: | 303-417-0500 |
Practice Address - Fax: | 720-859-3543 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-12-03 |
Last Update Date: | 2012-06-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CO | 06D1090464 | 291U00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 291U00000X | Laboratories | Clinical Medical Laboratory |