Provider Demographics
NPI:1104707884
Name:PATERNITY GENETICS DNA MOBILE SERVICE
Entity type:Organization
Organization Name:PATERNITY GENETICS DNA MOBILE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHLEBOTOMIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:ADRIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHLEBOTOMY CERTIFIED
Authorized Official - Phone:440-688-1692
Mailing Address - Street 1:11813 KENSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-5200
Mailing Address - Country:US
Mailing Address - Phone:440-688-1692
Mailing Address - Fax:
Practice Address - Street 1:11813 KENSINGTON AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-5200
Practice Address - Country:US
Practice Address - Phone:440-688-1692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health