Clongen Laboratories, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

1206 Issued in MD

Legal business name

CLONGEN LABORATORIES, LLC

Practice address

12321 Middlebrook Rd
Suite 120
Germantown, MD 20874-1591

Phone

(301) 916-0173

Fax

(301) 916-0175

NPI assigned

Feb 9, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Ahmed Fathy Kilani, PH.D.

Title

President and Laboratory Director

Phone

(301) 916-0173

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234137600000",
    "number": "1770722100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12321 MIDDLEBROOK RD",
            "address_2": "SUITE 120",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208741591",
            "telephone_number": "301-916-0173",
            "fax_number": "301-916-0175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12321 MIDDLEBROOK RD",
            "address_2": "SUITE 120",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208741591",
            "telephone_number": "301-916-0173",
            "fax_number": "301-916-0175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLONGEN LABORATORIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-09",
        "last_updated": "2009-02-09",
        "status": "A",
        "authorized_official_last_name": "KILANI",
        "authorized_official_first_name": "AHMED",
        "authorized_official_middle_name": "FATHY",
        "authorized_official_title_or_position": "PRESIDENT AND LABORATORY DIRECTOR",
        "authorized_official_telephone_number": "301-916-0173",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MD",
            "license": "1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Germantown, MD
• Providers in Germantown, MD by specialty
• Clinical Medical Laboratory in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2009; 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.