Provider Demographics
NPI:1538543731
Name:EXOSOME DIAGNOSTICS, INC.
Entity type:Organization
Organization Name:EXOSOME DIAGNOSTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-588-0522
Mailing Address - Street 1:266 2ND AVE # 200
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1166
Mailing Address - Country:US
Mailing Address - Phone:617-588-0500
Mailing Address - Fax:617-588-0580
Practice Address - Street 1:266 2ND AVE # 200
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-1166
Practice Address - Country:US
Practice Address - Phone:617-588-0500
Practice Address - Fax:617-588-0580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory