Green Clinics Laboratory, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

C1-0008033 Issued in DE

Legal business name

GREEN CLINICS LABORATORY, LLC

Practice address

1633 Sorghum Mill Rd
Dover, DE 19901-6810

Phone

(302) 734-5050

Fax

(302) 734-8080

NPI assigned

Sep 2, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Fady Joseph Gerges, M.D.NPI 1437211315

Title

Owner

Phone

(302) 734-5050

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DE2 enrollments

Enrollment records 2

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.

• Fady J Gerges, MD

  • Anatomic Pathology Physician
  • Dover, DE
  • NPI 1437211315
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611532800000",
    "number": "1154798585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 SORGHUM MILL RD",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199016810",
            "telephone_number": "302-734-5050",
            "fax_number": "302-734-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 SORGHUM MILL RD",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199016810",
            "telephone_number": "302-734-5050",
            "fax_number": "302-734-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN CLINICS LABORATORY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-02",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A",
        "authorized_official_last_name": "GERGES",
        "authorized_official_first_name": "FADY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-734-5050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "DE",
            "license": "C1-0008033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437211315",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lesmine London Gray
• Sheryl Gray
• Greater Health Associates LLC
• Greater Kent County Coalition Inc
• Brielle Camille Greco, PA-C
• Anitra Jeanette Green, LCSW
• Bernice Green
• Caroline Lea Green
• Megan Green, NP
• Arielle Greenberg

• Clinical Medical Laboratory in Dover, DE
• Providers in Dover, DE by specialty
• Clinical Medical Laboratory in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.