Iqgenetix LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

IQGENETIX LLC

Doing business as

IQGenetix LLC

Practice address

10300 Eaton PL Ste 440
Fairfax, VA 22030-2239

Phone

(866) 921-2415

Fax

(703) 738-7895

NPI assigned

Apr 4, 2023

Last updated

May 19, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffrey Glenn Mohler

Title

Ceo

Phone

(866) 921-2415

Specialties & licenses 1

Addresses

Other names 1

• IQGenetix LLC Doing business as

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

{
    "created_epoch": "1680566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684454400000",
    "number": "1598460990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10300 EATON PL STE 440",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302239",
            "telephone_number": "866-921-2415",
            "fax_number": "703-738-7895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 EATON PL STE 440",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302239",
            "telephone_number": "866-921-2415",
            "fax_number": "703-738-7895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IQGENETIX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-04",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A",
        "authorized_official_last_name": "MOHLER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "GLENN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "866-921-2415"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IQGenetix LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Clinical Medical Laboratory in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; 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.