NPIMap

Organization Active NPI

Genesis Laboratories, Inc.

  • Clinical Medical Laboratory
  • Riverside, CA
National Provider Identifier
1912129222
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
CLF10367 Issued in CA
Legal business name
GENESIS LABORATORIES, INC.
Practice address
5750 Division St
Suite 104
Riverside, CA 92506-3269
Phone
(951) 781-9923
Fax
(951) 781-9924
NPI assigned
May 3, 2007
Last updated
May 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Authorized official

Name
Dr. Robin Dawn Clark, M.D.NPI 1902826498
Title
President-Owner
Phone
(951) 781-9923

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X CLF10367 CA Primary

Addresses

Primary practice location

5750 Division St
Suite 104
Riverside, CA 92506-3269

Mailing address

5750 Division St
Suite 104
Riverside, CA 92506-3269
Phone (951) 781-9923

Other identifiers 1

IdentifierTypeStateIssuer
LAB76729FMedicaidCA

National Provider Directory

National Provider Directory

Member of 1

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

Locations

5750 Division St
Ste 104
Riverside, CA 92506
Phone (951) 781-9923

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1912129222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 DIVISION ST",
            "address_2": "SUITE 104",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063269",
            "telephone_number": "951-781-9923",
            "fax_number": "951-781-9924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 DIVISION ST",
            "address_2": "SUITE 104",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063269",
            "telephone_number": "951-781-9923",
            "fax_number": "951-781-9924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS LABORATORIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "PRESIDENT-OWNER",
        "authorized_official_telephone_number": "951-781-9923",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLF10367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB76729F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.