Mygenomics, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MYGENOMICS, LLC

Practice address

11535 Park Woods Cir
Suite E
Alpharetta, GA 30005-4490

Phone

(855) 647-4363

NPI assigned

Feb 21, 2014

Organization subpart

No

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

Authorized official

Name

Shoeb Ahmad, PHD

Title

Owner

Phone

(855) 647-4363

Specialties & licenses 2

Addresses

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1392940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707523200000",
    "number": "1720403116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11535 PARK WOODS CIR",
            "address_2": "SUITE E",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054490",
            "telephone_number": "855-647-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11535 PARK WOODS CIR",
            "address_2": "SUITE E",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054490",
            "telephone_number": "855-647-4363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYGENOMICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-21",
        "last_updated": "2024-02-10",
        "certification_date": "2024-02-10",
        "status": "A",
        "authorized_official_last_name": "AHMAD",
        "authorized_official_first_name": "SHOEB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "855-647-4363",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "207ZP0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Molecular Genetic Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Clinical Medical Laboratory in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.