My Genius Lab LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MY GENIUS LAB LLC

Doing business as

Genics Laboratories

Practice address

655 N Central Ave Ste 1734
Glendale, CA 91203-1422

Phone

(818) 649-8611

Fax

(323) 544-6044

NPI assigned

Feb 18, 2022

Last updated

Feb 18, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

MY GENIUS LAB LLCAs reported in NPPES

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

Authorized official

Name

Kevin Setanyan

Title

Managing Partner

Phone

(818) 649-8611

Specialties & licenses 1

Addresses

Other names 1

• GENICS LABORATORIES Doing business as

Part of

My Genius Lab LLC

Locations

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

{
    "created_epoch": "1645142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645142400000",
    "number": "1447905369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 N CENTRAL AVE STE 1734",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912031422",
            "telephone_number": "818-649-8611",
            "fax_number": "323-544-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 N CENTRAL AVE STE 1734",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912031422",
            "telephone_number": "818-649-8611",
            "fax_number": "323-544-6044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY GENIUS LAB LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MY GENIUS LAB LLC",
        "enumeration_date": "2022-02-18",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A",
        "authorized_official_last_name": "SETANYAN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "818-649-8611"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GENICS LABORATORIES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tamila Mustafaeva, AGACNP - BC
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• Jae Hong Myung, DDS

• Clinical Medical Laboratory in Glendale, CA
• Providers in Glendale, 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 Feb 18, 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.