Iqgenetix LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

IQGENETIX LLC

Doing business as

IQGenetix LLC

Practice address

11225 Assett Loop Ste 100
Manassas, VA 20109-3994

Phone

(866) 921-2415

Fax

(571) 379-4847

NPI assigned

Oct 14, 2020

Last updated

May 4, 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

Mr. Jeffrey Glenn Mohler

Title

Ceo

Phone

(240) 416-4364

Specialties & licenses 1

Addresses

Other names 1

• IQGenetix LLC Doing business as

Locations

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683158400000",
    "number": "1649878364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11225 ASSETT LOOP STE 100",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201093994",
            "telephone_number": "866-921-2415",
            "fax_number": "571-379-4847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11225 ASSETT LOOP STE 100",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201093994",
            "telephone_number": "866-921-2415",
            "fax_number": "571-379-4847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IQGENETIX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-14",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "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": "240-416-4364",
        "authorized_official_name_prefix": "Mr."
    },
    "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 Manassas, VA
• Providers in Manassas, 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 4, 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.