Esoterix Genetic Laboratories, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ESOTERIX GENETIC LABORATORIES, LLC

Practice address

17772 17TH St
Suite 200 Room 217
Tustin, CA 92780-1944

Phone

(800) 710-1800

NPI assigned

Nov 16, 2010

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

VP

Phone

(800) 222-7566

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466726400000",
    "number": "1922309376",
    "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",
            "telephone_number": "800-222-7566",
            "fax_number": "336-436-1048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17772 17TH ST",
            "address_2": "SUITE 200 ROOM 217",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927801944",
            "telephone_number": "800-710-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESOTERIX GENETIC LABORATORIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-16",
        "last_updated": "2016-06-24",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "800-222-7566"
    },
    "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": "05D0642715",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey G Erb, NMD
• Erkan Ereren, MD
• Erin Fraser Benesch, Inc
• Gwyneth Kerr Erwin, PH.D., PSY.D.
• Wilfredo T Escober, M.D.
• Mona Espanola
• Marchelle Ethel Esparza, MPT, OCS
• Yesenia Esparza
• Edgar Espinoza
• Leslie Espinoza, LCSW

• Clinical Medical Laboratory in Tustin, CA
• Providers in Tustin, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2016; 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.