Organization
GENUS3 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY JOHNSON (OWNER)
(516) 590-7089
Entity
Organization
Contact information
Practice address
25319 INTERSTATE 45 STE 102, SPRING, TX 77380-3551
(832) 603-1086
(866) 252-3902
Mailing address
25319 INTERSTATE 45 STE 102, SPRING, TX 77380-3551
(832) 603-1086
(866) 252-3902
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45D2176742
CLIA
—
Enumeration date
02/07/2020
Last updated
02/07/2020
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