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GENESIS MEDICAL DIAGNOSTICS PLLC NPI 1245803402


NPI Information

NPI: 1245803402
Provider Name: GENESIS MEDICAL DIAGNOSTICS PLLC
Classification: Clinical Medical Laboratory - 291U00000X
Entity Type: Organization

CLIA Number: 45D2216609

Address:
4195 NACO PERRIN BLVD
SAN ANTONIO, TX
ZIP 78217
Phone: (210) 276-0045
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GENESIS MEDICAL DIAGNOSTICS PLLC is a clinical medical laboratory in San Antonio, TX. The provider is (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. GENESIS MEDICAL DIAGNOSTICS PLLC NPI is 1245803402. The provider is registered as an organization entity type.

The provider's business location address is:

4195 NACO PERRIN BLVD
SAN ANTONIO, TX
ZIP 78217-505
Phone: (210) 276-0045
Fax: (832) 565-1921

The provider's authorized official is Ewan D. Johnson .
The authorized official title is Ceo/founder and has the following contact phone number (281) 415-6687.

The CLIA number assigned to this NPI record is 45D2216609 - independent with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/23/2021 and was last updated on 9/16/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1291U00000XClinical Medical LaboratoryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
145D2216609OTHERTEXASCLIA NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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