Csi Genetics, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

060-327 Issued in GA

Legal business name

CSI GENETICS, LLC

Doing business as

CSI Genetics, LLC

Practice address

11525 Park Woods Cir
Alpharetta, GA 30005-4482

Phone

(678) 205-4346

Fax

(678) 205-4347

NPI assigned

Nov 10, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Ron H. Ghafary

Title

Owner

Phone

(678) 205-4346

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• CSI Genetics, LLC Doing business as

Locations

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295806552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11525 PARK WOODS CIR",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054482",
            "telephone_number": "678-205-4346",
            "fax_number": "678-205-4347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11525 PARK WOODS CIR",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054482",
            "telephone_number": "678-205-4346",
            "fax_number": "678-205-4347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSI GENETICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GHAFARY",
        "authorized_official_first_name": "RON",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-205-4346",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "GA",
            "license": "060-327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1458431",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36203900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CSI Genetics, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Clinical Medical Laboratory in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.