OrganizationGenetic Technological Innovations, Llc(<Unavail>)Clinical Medical LaboratoryLaboratoriesPractice Address13402 N Scottsdale Rd, Scottsdale, AZ 85254-4054(480) 674-6565(877) 993-2484PECOS EnrollmentBased on the most recent information from CMS, provider Genetic Technological Innovations, Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1265854855Provider TypeOrganizationFull NameGenetic Technological Innovations, LlcOther Name<Unavail>SubpartNoEnumeration Date1/15/2014Last Updated8/20/2024Contact InformationPractice LocationPractice Address13402 N Scottsdale Rd, Scottsdale, AZ 85254-4054Phone(480) 674-6565Fax(480) 265-4453Mailing LocationMailing Address14500 N Northsight Blvd Ste 100, Scottsdale, AZ 85260-3659Phone(877) 993-2484Fax(480) 265-4453Authorized OfficialNameGlimcher, Nicholas (Ceo)Phone(480) 476-8761Provider TaxonomiesCodeDescriptionLicenseCode291U00000XPrimaryDescriptionClinical Medical LaboratoryLaboratoriesLicense05D2071616CaliforniaProvider IdentifiersIDDescriptionIssuerID3964041DescriptionMedicaidIssuerUnlistedTexasID7100347080DescriptionMedicaidIssuerUnlistedKentucky