Organization
GENLABX LLC
Active
Other names
GenLabX
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HAMIDREZA VAHEDIPOUR (CEO)
(336) 501-4899
Entity
Organization
Contact information
Practice address
1939 ROLAND CLARKE PL STE 100, RESTON, VA 20191-1443
(202) 999-2564
Mailing address
1939 ROLAND CLARKE PL STE 100, RESTON, VA 20191-1443
Taxonomy
Speciality
Code
Description
License number
State
2083T0002X
Medical Toxicology (Preventive Medicine) Physician
Primary
—
—
Other
Enumeration date
02/01/2019
Last updated
02/01/2019
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