Provider Demographics
NPI:1174419758
Name:SYNERGENIX DIAGNOSTICS
Entity type:Organization
Organization Name:SYNERGENIX DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEY
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-607-3875
Mailing Address - Street 1:9001 WOODYARD RD STE C
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-4264
Mailing Address - Country:US
Mailing Address - Phone:202-607-3875
Mailing Address - Fax:
Practice Address - Street 1:9001 WOODYARD RD STE C
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4264
Practice Address - Country:US
Practice Address - Phone:202-607-3875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory