Cynogen, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CLF00339441 Issued in CA

Legal business name

CYNOGEN, INC.

Practice address

25901 Commercentre Dr
Lake Forest, CA 92630-8805

Phone

(877) 429-6643

Fax

(949) 587-7502

NPI assigned

Apr 19, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Hallie A Stohler

Title

Office Admin

Phone

(949) 587-7516

Specialties & licenses 2

Addresses

Other names 1

• PersonalizeDx Doing business as

Locations

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

{
    "created_epoch": "1271635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505347200000",
    "number": "1972829752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25901 COMMERCENTRE DR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926308805",
            "telephone_number": "877-429-6643",
            "fax_number": "949-587-7502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25901 COMMERCENTRE DR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926308805",
            "telephone_number": "877-429-6643",
            "fax_number": "949-587-7502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CYNOGEN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-19",
        "last_updated": "2017-09-14",
        "status": "A",
        "authorized_official_last_name": "STOHLER",
        "authorized_official_first_name": "HALLIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE ADMIN",
        "authorized_official_telephone_number": "949-587-7516",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLF00339441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PersonalizeDx",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in Lake Forest, CA
• Providers in Lake Forest, 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 Sep 14, 2017; 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.