Esoterix Genetic Laboratories, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ESOTERIX GENETIC LABORATORIES, LLC

Practice address

856 Brown Rd
Bridgewater, NJ 08807-1239

Phone

(732) 853-5874

NPI assigned

Oct 17, 2023

Organization subpart

No

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

Authorized official

Name

Kimberly T Williams

Title

Vice President

Phone

(336) 222-7566

Specialties & licenses 1

Addresses

Other identifiers 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Laboratory Corporation of America Holdings

  • Clinical Medical Laboratory
  • Cromwell, CT
  • NPI 1700517984

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1697500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1841072675",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "856 BROWN RD",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088071239",
            "telephone_number": "732-853-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESOTERIX GENETIC LABORATORIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-17",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "336-222-7566"
    },
    "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": "31D2290336",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Jean Ellmer, AU. D
• Lauren Elizabeth Emerson, PT, DPT
• Justine Encinas
• Enlyv Me Inc
• Epiphany Dermatology of New Jersey LLC
• Taylor Evans
• Spencer Evelyn, RBT
• Everest Medical Associates, P.C.
• Kevin Evitts
• Neile Fahsbender, LCSW

• Clinical Medical Laboratory in Bridgewater, NJ
• Providers in Bridgewater, NJ by specialty
• Clinical Medical Laboratory in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.