Genesis Reference Laboratories, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

GENESIS REFERENCE LABORATORIES, LLC

Practice address

6547 S Racine Cir Ste 1100
Centennial, CO 80111-6456

Phone

(407) 232-7172

NPI assigned

Sep 19, 2023

Organization subpart

No

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

Authorized official

Name

Philip David Freitas

Title

Managing Partner

Phone

(407) 232-7172

Specialties & licenses 1

Addresses

Other names 1

• Genesis Reference Laboratories of Colorado Other name

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Genesis Reference Laboratories, LLC

  • Clinical Medical Laboratory
  • Orlando, FL
  • NPI 1982091617

  9739477217

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Genesis Reference Laboratories LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Genesis Reference Laboratories, LLC

  • Clinical Medical Laboratory
  • Orlando, FL
  • NPI 1982091617
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michelle Jean Taylor, D.O.

  • Clinical Pathology Physician
  • Longwood, FL
  • NPI 1033438296
  NPD (past)

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

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695081600000",
    "number": "1639957897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7924 FOREST CITY RD STE 210",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328102925",
            "telephone_number": "407-232-7172",
            "fax_number": "407-289-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6547 S RACINE CIR STE 1100",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801116456",
            "telephone_number": "407-232-7172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS REFERENCE LABORATORIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-19",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A",
        "authorized_official_last_name": "FREITAS",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "407-232-7172"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Genesis Reference Laboratories of Colorado",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Biniam Taddesse Gemeda
• Sarah Gemmell, MA, LPC, NCC
• Tonya Genazzi, AU.D.
• Dennis P Genereux, MD
• Genesis Chiropractic Spine and Sports Center
• Sydney Genovese
• Gentle Giants Therapy and Consulting Center
• Gentle Hearts 3 LLC
• Karin J George, MS PT
• Lacey Claire George, PA-C

• Clinical Medical Laboratory in Centennial, CO
• Providers in Centennial, CO by specialty
• Clinical Medical Laboratory in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.