Organization · NPI-2

Proteus Genomics, LLC

Clinical Medical Laboratory · Hattiesburg, MS

NPI number1558097592
StatusActive
Last updated in NPPESJul 30, 2022

Details

NPI
1558097592
Entity type
Organization (NPI-2)
Legal business name
Proteus Genomics, LLC
Organization subpart
Yes
Enumeration date
Jul 30, 2022
Certification date
Jul 27, 2022
Last updated
Jul 30, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
291U00000X Clinical Medical Laboratory––Yes

Practice location

6766 U S Highway 98 Ste 1b
Hattiesburg, MS 39402-8443

Phone 601-549-4182

Mailing address

6766 U S Highway 98 Ste 1b
Hattiesburg, MS 39402-8443

Authorized official

Michael Griffith
Member/Manager
2054787302

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Clinical Medical Laboratory providers in Hattiesburg, MS