Provider Demographics
NPI:1609528892
Name:ONCOCYTE, CORPORATION
Entity type:Organization
Organization Name:ONCOCYTE, CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:WHITE
Authorized Official - Last Name:FULTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-352-9783
Mailing Address - Street 1:PO BOX 120293
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75312-0293
Mailing Address - Country:US
Mailing Address - Phone:844-679-6600
Mailing Address - Fax:949-271-4972
Practice Address - Street 1:2 INTERNATIONAL PLZ STE 510
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-2093
Practice Address - Country:US
Practice Address - Phone:844-679-6600
Practice Address - Fax:949-271-4972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory