Provider Demographics
NPI:1356009849
Name:THE LAB GENIUS INC.
Entity Type:Organization
Organization Name:THE LAB GENIUS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER/COO
Authorized Official - Prefix:
Authorized Official - First Name:DARRYLE
Authorized Official - Middle Name:MAURICE
Authorized Official - Last Name:FARRAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-245-5543
Mailing Address - Street 1:777 CLEVELAND AVE SW STE 516
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-7115
Mailing Address - Country:US
Mailing Address - Phone:404-245-5543
Mailing Address - Fax:866-502-0926
Practice Address - Street 1:777 CLEVELAND AVE SW STE 516
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30315-7115
Practice Address - Country:US
Practice Address - Phone:404-245-5543
Practice Address - Fax:866-502-0926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization