Organization
NEXTGEN LABORATORIES, INC.
Active
Parent organization
GORDIAN MEDICAL, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
GORDIAN MEDICAL, INC.
Authorized official
JOSEPH DEL SIGNORE (CEO)
(949) 467-9770
Entity
Organization
Contact information
Practice address
4229 BIRCH ST, SUITE 130, NEWPORT BEACH, CA 92660-1902
(949) 467-9770
(949) 272-3252
Mailing address
4229 BIRCH ST, SUITE 130, NEWPORT BEACH, CA 92660-1902
(949) 467-9770
(949) 272-3252
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF00011097
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003203849A
—
GA
05
—
0186222
—
OH
05
—
04373789
—
MS
05
—
0589071
—
NJ
05
—
100067476
—
WI
05
—
10026615500
—
NE
05
—
1029235
—
VT
05
—
1033640650001
—
PA
01
—
1558755496
MEDICARE CROSSOVER
CA
05
—
1558755496
—
IA
05
—
1558755496
—
ID
05
—
1558755496
—
IL
05
—
1558755496
—
MN
05
—
1558755496
—
MO
05
—
1558755496
—
MT
05
—
1558755496
—
UT
05
—
1558755496
—
WY
05
—
200671730A
—
OK
05
—
2081765
—
WA
05
—
230378
—
AZ
05
—
2431684
—
LA
05
—
29212545
—
CO
05
—
300001174
—
IN
05
—
534401800
—
MD
05
—
7100449550
—
KY
05
—
86272772
—
NM
01
—
CB262885
MEDICARE PTAN
—
05
—
L00569
—
SC
05
—
Q052462
—
TN
Enumeration date
03/27/2015
Last updated
09/28/2023
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