Genotox Laboratories LTD

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

GENOTOX LABORATORIES LTD

Practice address

2170 Woodward
Suite 100
Austin, TX 78744-1074

Phone

(512) 600-6601

Fax

(512) 600-6602

NPI assigned

Nov 29, 2012

Organization subpart

No

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

Authorized official

Name

Matthew Frederick McCarty, MD

Title

Ceo

Phone

(512) 600-6601

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1354147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1215272406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2170 WOODWARD",
            "address_2": "SUITE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787441074",
            "telephone_number": "512-600-6601",
            "fax_number": "512-600-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2170 WOODWARD",
            "address_2": "SUITE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787441074",
            "telephone_number": "512-600-6601",
            "fax_number": "512-600-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENOTOX LABORATORIES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MCCARTY",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-600-6601",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3313918",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Austin, TX
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.