Provider Demographics
NPI:1871585067
Name:REVVITY OMICS, INC.
Entity type:Organization
Organization Name:REVVITY OMICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LABORATORY DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:QUASHNOCK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:724-227-4913
Mailing Address - Street 1:PERKINELMER GENETICS, INC.
Mailing Address - Street 2:250 INDUSTRY DRIVE, SUITE 400
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15275-1017
Mailing Address - Country:US
Mailing Address - Phone:412-220-2300
Mailing Address - Fax:412-220-0784
Practice Address - Street 1:250 INDUSTRY DR STE 400
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15275-1017
Practice Address - Country:US
Practice Address - Phone:412-220-2300
Practice Address - Fax:412-220-0784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-16
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA022936291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory