Genlabx LLC

Primary specialty

Medical Toxicology (Preventive Medicine) PhysicianTaxonomy code 2083T0002X

Legal business name

GENLABX LLC

Doing business as

GenLabX

Practice address

1939 Roland Clarke PL Ste 100
Reston, VA 20191-1443

Phone

(202) 999-2564

NPI assigned

Feb 1, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Hamidreza Vahedipour

Title

Ceo

Phone

(336) 501-4899

Specialties & licenses 1

Addresses

Other names 1

• GenLabX Doing business as

Locations

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

{
    "created_epoch": "1548979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548979200000",
    "number": "1750846945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 ROLAND CLARKE PL STE 100",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201911443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1939 ROLAND CLARKE PL STE 100",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201911443",
            "telephone_number": "202-999-2564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENLABX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-01",
        "last_updated": "2019-02-01",
        "status": "A",
        "authorized_official_last_name": "VAHEDIPOUR",
        "authorized_official_first_name": "HAMIDREZA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-501-4899",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2083T0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Medical Toxicology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GenLabX",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Medical Toxicology (Preventive Medicine) Physician in Reston, VA
• Providers in Reston, VA by specialty
• Medical Toxicology (Preventive Medicine) Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; 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.