Genus3 LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

GENUS3 LLC

Practice address

25319 Interstate 45 Ste 102
Spring, TX 77380-3551

Phone

(832) 603-1086

Fax

(866) 252-3902

NPI assigned

Feb 7, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jerry Johnson

Title

Owner

Phone

(516) 590-7089

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581033600000",
    "number": "1063044097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25319 INTERSTATE 45 STE 102",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773803551",
            "telephone_number": "832-603-1086",
            "fax_number": "866-252-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25319 INTERSTATE 45 STE 102",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773803551",
            "telephone_number": "832-603-1086",
            "fax_number": "866-252-3902"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13600 Breton Ridge St Unit 9C",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770705983",
            "country_code": "US",
            "telephone_number": "832-603-1086",
            "fax_number": "866-252-3902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GENUS3 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-07",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-590-7089",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "45D2176742",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Spring, TX
• Providers in Spring, TX by specialty
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.