ESOTERIX GENETIC LABORATORIES, LLC (NPI# 1023319407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023319407 |
| Entity Type | Organization |
| Organization Name | ESOTERIX GENETIC LABORATORIES, LLC |
| Practice Address |
2440 S Sepulveda Blvd Ste 100 Los Angeles CA 90064-1784 |
| Mailing Address |
Po Box 2240 Burlington NC 27216-2240 |
| Practice Telephone | 3106890610 |
| Mailing Telephone | 8002227566 |
| Mailing Fax Number | 3364365153 |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2014-01-02 |
| Authorized Official Name | KIMBERLY WILLIAMS (VP) |
| Authorized Official Telephone | 8002227566 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QG0250X |
Clinic/Center Specialization: Genetics |
Ambulatory Health Care Facilities | ||
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CLIA | 05D0907763 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124536107 | Esoterix Genetic Laboratories, LLC | Clinical Medical Laboratory | 3 Forest Pkwy, Shelton, CT 06484-6122 | 2018-01-12 |
| 1659672004 | Esoterix Genetic Laboratories, LLC | Clinical Medical Laboratory | 533 W 57th St, New York, NY 10019-2901 | 2010-11-16 |
| 1043511496 | Esoterix Genetic Laboratories, LLC | Clinical Medical Laboratory | 12906 Tampa Oaks Blvd, Ste 300, Temple Terrace, FL 33637-1153 | 2010-11-16 |
| 1588965941 | Esoterix Genetic Laboratories, LLC | Clinical Medical Laboratory | 8300 Old Courthouse Rd Ste 240, Vienna, VA 22182-3822 | 2010-11-16 |
| 1467753814 | Esoterix Genetic Laboratories, LLC | Clinical Medical Laboratory | 4310 E Cotton Center Blvd Ste 120, Phoenix, AZ 85040-8857 | 2010-11-16 |
| 1649572017 | Esoterix Genetic Laboratories, LLC | Clinical Medical Laboratory | 3400 Computer Dr, Westborough, MA 01581-1771 | 2010-11-17 |
| 1679874028 | Esoterix Genetic Laboratories, LLC | Clinical Medical Laboratory | 1054 W Town and Country Rd, Orange, CA 92868-4716 | 2010-11-16 |
| 1801197256 | Esoterix Genetic Laboratories, LLC | Clinical Medical Laboratory | 2000 Vivigen Way, Santa Fe, NM 87505-5600 | 2010-11-16 |
| 1922309376 | Esoterix Genetic Laboratories, LLC | Clinical Medical Laboratory | 17772 17th St, Suite 200 Room 217, Tustin, CA 92780-1944 | 2010-11-16 |
| 1689975021 | Esoterix Genetic Laboratories, LLC | Clinical Medical Laboratory | 3400 Computer Dr, Westborough, MA 01581-1771 | 2010-11-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ESOTERIX GENETIC LABORATORIES, LLC | 3400 Computer Dr, Westborough, MA 01581-1771 |
| Colorado Business Entities | Esoterix Genetic Laboratories, LLC | 531 South Spring Street, Burlington, NC 27215 |
| Massachusetts Corporations | ESOTERIX GENETIC LABORATORIES, LLC | 231 Maple Avenue, Burlington, NC 27215 |
| Ohio Business Entities | ESOTERIX GENETIC LABORATORIES, LLC | 358 South Main Street, Burlington, NC 27215 |
| Oklahoma Business Registrations | ESOTERIX GENETIC LABORATORIES, LLC | 358 S Main St, Burlington, NC 27215 |
| Street Address |
2440 S SEPULVEDA BLVD STE 100 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90064-1784 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699752766 | National Genetics Institute | Clinical Medical Laboratory | 2440 S Sepulveda Blvd, Suite 235, Los Angeles, CA 90064-1784 | 2005-12-29 |
| 1366881294 | William Munday | Dermatology | 2440 S Sepulveda Blvd, Los Angeles, CA 90064-1784 | 2013-06-25 |
| 1043556244 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 2440 S Sepulveda Blvd, Suite 220, Los Angeles, CA 90064-1784 | 2012-12-17 |
| 1366646283 | Honggang Shen | Pathology | 2440 S Sepulveda Blvd, Suite 181, Los Angeles, CA 90064-1784 | 2007-06-13 |
| 1922180801 | Lyndon D Su | Pathology | 2440 S Sepulveda Blvd, Suite 235, Los Angeles, CA 90064-1784 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134727597 | Barbara K. Polland | Marriage & Family Therapist | 10533 Rountree Rd., Los Angeles, CA 90064 | 2020-10-16 |
| 1912542994 | Reproductive Medicine Associates of Socal Ambulatory Surgery Center | Clinic/Center | 11500 W Olympic Blvd, Ste# 150, Los Angeles, CA 90064 | 2019-11-13 |
| 1376022012 | Payersdirect, Inc. | Radiology | 11845 W Olympic Blvd Ste 1100w, Los Angeles, CA 90064 | 2018-08-13 |
| 1013404136 | Jeannie Wakamatsu | Dietitian, Registered | 10312 Almayo Ave., Suite 6, Los Angeles, CA 90064 | 2018-04-13 |
| 1487153474 | Victor Louie | Behavior Technician | 11835 W Olympic Blvd Suite 140e, Los Angeles, CA 90064 | 2018-02-06 |
| 1538683842 | Ana Grinfeld | Behavioral Analyst | 11835 W Olympic Blvd Ste 140e, Los Angeles, CA 90064 | 2017-07-28 |
| 1407386089 | Ovsanna Stepanyan | Rehabilitation Practitioner | 11080 W Olimpic Blvd, La, CA 90064 | 2017-06-15 |
| 1952768012 | Grace Gayles | Behavioral Analyst | 11835 W. Olympic Blvd., Suite 140e, Los Angeles, CA 90064 | 2016-01-20 |
| 1669841003 | Jessica Hildebrandt | Occupational Therapy Assistant | 2446 S Westgate Ave, Los Angeles, CA 90064 | 2015-09-16 |
| 1033592571 | Joshua Busse | Family Medicine | 11845 Olympic Boulevard, Los Angeles, CA 90064 | 2015-07-01 |
| Find all providers in zip 90064 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
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|---|---|---|---|---|
| 1518565514 | Clarity Mobile Venture LLC | Clinical Medical Laboratory | 651 World Way, Los Angeles, CA 90045-5815 | 2020-10-12 |
| 1134748312 | Steaman Laboratory Incorporated | Clinical Medical Laboratory | 3631 Crenshaw Blvd Ste 103, Los Angeles, CA 90016-4869 | 2020-04-08 |
| 1528619970 | Community Laboratory Inc | Clinical Medical Laboratory | 1919 W 7th St Unit L, Los Angeles, CA 90057-4103 | 2019-09-26 |
| 1982173423 | Sequence46, LLC | Clinical Medical Laboratory | 5777 W Century Blvd Ste 540, Los Angeles, CA 90045-5688 | 2018-11-14 |
| 1699271502 | Medbetter Health Solutions, LLC | Clinical Medical Laboratory | 11669 Rochester Ave Apt 101, Los Angeles, CA 90025-2381 | 2018-04-02 |
| 1144769068 | Flow Health Laboratories LLC | Clinical Medical Laboratory | 8885 Venice Blvd Ste 104, Los Angeles, CA 90034-3242 | 2017-02-13 |
| 1699226415 | Kathleen Ann Kelly | Clinical Medical Laboratory | David Geffen Medical Ctr Ucla 10833 Le Conte Ave, Mailroom A3-215 Chs, Mailcode 173216, Los Angeles, CA 90095-1732 | 2016-10-17 |
| 1306203229 | Quick and Easy Hplebotomy Services, LLC | Clinical Medical Laboratory | 9029 Airport Blvd Unit 91896, Los Angeles, CA 90009-4904 | 2016-01-22 |
| 1992161632 | Pachulski Industries Inc | Clinical Medical Laboratory | 100 Copa De Oro Rd, Los Angeles, CA 90077-3802 | 2016-01-11 |
| 1851761282 | Dynamic Clinical Laboratories, Inc. | Clinical Medical Laboratory | 516 N Larchmont Blvd, Los Angeles, CA 90004-1306 | 2015-09-28 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90064 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.