Provider Demographics
NPI:1366166290
Name:TAAG GENETICS CORP.
Entity type:Organization
Organization Name:TAAG GENETICS CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-394-3588
Mailing Address - Street 1:200 W NORTH AVE STE 700
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-6242
Mailing Address - Country:US
Mailing Address - Phone:630-912-5988
Mailing Address - Fax:630-946-5555
Practice Address - Street 1:200 W NORTH AVE STE 700
Practice Address - Street 2:
Practice Address - City:WEST CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60185-6242
Practice Address - Country:US
Practice Address - Phone:630-912-5988
Practice Address - Fax:630-946-5555
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TAAG GENETICS CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory