NPIMap

Organization Active NPI

Esoterix Genetic Laboratories, LLC

  • Clinical Medical Laboratory
  • Vienna, VA
National Provider Identifier
1588965941
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
ESOTERIX GENETIC LABORATORIES, LLC
Practice address
8300 Old Courthouse Rd Ste 240
Vienna, VA 22182-3822
Phone
(703) 288-0360
NPI assigned
Nov 16, 2010
Last updated
Nov 16, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

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

Authorized official

Name
Mr. William B Hayes
Title
Cfo Evp Treasurer
Phone
(800) 222-7566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

8300 Old Courthouse Rd Ste 240
Vienna, VA 22182-3822

Mailing address

PO Box 2240
Burlington, NC 27216-2240
Phone (800) 222-7566

Other identifiers 1

IdentifierTypeStateIssuer
49D1020888OtherCLIA

National Provider Directory

National Provider Directory
Tax ID family
Esoterix Genetic Laboratories LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289865600000",
    "number": "1588965941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2240",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272162240",
            "telephone_number": "800-222-7566",
            "fax_number": "336-436-1048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 OLD COURTHOUSE RD STE 240",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823822",
            "telephone_number": "703-288-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESOTERIX GENETIC LABORATORIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-16",
        "last_updated": "2010-11-16",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CFO EVP TREASURER",
        "authorized_official_telephone_number": "800-222-7566",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "49D1020888",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; 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.