Simplify Genomics Clinical Laboratory

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SIMPLIFY GENOMICS CLINICAL LABORATORY

Practice address

440 Stevens Avenue, Suite 200
Solana Beach, CA 92075

Phone

(847) 668-8090

Fax

(888) 443-4153

NPI assigned

Feb 1, 2017

Last updated

Jan 9, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Travis Lacey

Title

Chief Executive Officer

Phone

(847) 668-8090

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Neogenomics Laboratories Inc

  • Clinical Medical Laboratory
  • San Diego, CA
  • NPI 1215625165

  O20071116000642

  Same enrollment
• Neogenomics Laboratories Inc

  • Clinical Medical Laboratory
  • Pasadena, CA
  • NPI 1346645512

  O20071116000642

  Same enrollment
• Neogenomics Laboratories Inc

  • Clinical Medical Laboratory
  • Sierra Madre, CA
  • NPI 1386268365

  O20071116000642

  Same enrollment
• Neogenomics Laboratories Inc

  • Clinical Medical Laboratory
  • Aliso Viejo, CA
  • NPI 1447437355

  O20071116000642

  Same enrollment
• Neogenomics Laboratories Inc

  • Clinical Medical Laboratory
  • Tustin, CA
  • NPI 1639793615

  O20071116000642

  Same enrollment
• Neogenomics Laboratories Inc

  • Clinical Medical Laboratory
  • Irvine, CA
  • NPI 1699176768

  O20071116000642

  Same enrollment
• Neogenomics Laboratories Inc

  • Clinical Medical Laboratory
  • Chatsworth, CA
  • NPI 1710127279

  O20071116000642

  Same enrollment
• Neogenomics Laboratories Inc

  • Clinical Medical Laboratory
  • Carlsbad, CA
  • NPI 1740240753

  O20071116000642

  Same enrollment
• Neogenomics Laboratories Inc

  • Clinical Medical Laboratory
  • Aliso Viejo, CA
  • NPI 1841927936

  O20071116000642

  Same enrollment
• Neogenomics Laboratories Inc

  • Clinical Medical Laboratory
  • Fresno, CA
  • NPI 1912307547

  O20071116000642

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chloe Grace Myers

  • Genetic Counselor (M.S.)
  • San Diego, CA
  • NPI 1366364986
  NPD (past)

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

{
    "created_epoch": "1485907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704758400000",
    "number": "1104364983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 STEVENS AVENUE, SUITE 200",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "92075",
            "telephone_number": "847-668-8090",
            "fax_number": "888-443-4153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 STEVENS AVENUE, SUITE 200",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "92075",
            "telephone_number": "847-668-8090",
            "fax_number": "888-443-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMPLIFY GENOMICS CLINICAL LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-01",
        "last_updated": "2024-01-09",
        "certification_date": "2023-04-18",
        "status": "A",
        "authorized_official_last_name": "LACEY",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "847-668-8090"
    },
    "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": "05D2167801",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPH CLINICAL AND PUBLIC HEALTH LABORATORY LICENSE",
            "identifier": "CLF-00353852",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessy Sidhu, DMD
• Edward Allen Siegel, M.D.
• Sean Siemens, PT
• Carolyn Siewiorek
• Kerry Simmonds, DPT
• G. Preston Sims, PH.D.
• April Lynn Sisk, COTA
• Autumn Siverling
• Angela M Smith, DC
• Kevin Matthew Smith, MD

• Clinical Medical Laboratory in Solana Beach, CA
• Providers in Solana Beach, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.