Active NPI
Esoterix Genetic Laboratories, LLC
- Clinical Medical Laboratory
- Orange, CA
National Provider Identifier
1679874028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- ESOTERIX GENETIC LABORATORIES, LLC
- Practice address
- 1054 W Town and Country Rd
Orange, CA 92868-4716 - Phone
- (714) 245-9240
- NPI assigned
- Nov 16, 2010
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
1054 W Town and Country Rd
Orange, CA 92868-4716
Mailing address
PO Box 2240
Burlington, NC 27216-2240
Phone (800) 222-7566
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05D0667837 | Other | CLIA |
National Provider Directory
National Provider DirectoryNPI 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": "1368576000000",
"number": "1679874028",
"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": "1054 W TOWN AND COUNTRY RD",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684716",
"telephone_number": "714-245-9240"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ESOTERIX GENETIC LABORATORIES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2010-11-16",
"last_updated": "2013-05-15",
"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": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA",
"identifier": "05D0667837",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.