IVERSON GENETIC DIAGNOSTICS, INC. (NPI# 1992998157) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992998157 |
| Entity Type | Organization |
| Organization Name | IVERSON GENETIC DIAGNOSTICS, INC. |
| Other Organization Name | IVERSON GENETIC DIAGNOSTICS INC |
| Practice Address |
645 Meeting Street Charleston SC 29403 |
| Practice Telephone | 8437895912 |
| Practice Fax Number | 8889099784 |
| Mailing Telephone | 8437895912 |
| Mailing Fax Number | 8889099784 |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2016-11-02 |
| Authorized Official Name | MR. JOSEPH CLOUSE (CEO) |
| Authorized Official Telephone | 7202847526 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 291U00000X | Clinical Medical Laboratory | MTS-5156 | WA | Laboratories |
| Y | 291U00000X | Clinical Medical Laboratory | MTSC.FS.60001788 | WA | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | CLIA # | 50D1072592 | 01 |
| WA | CLIA | 50D1083740 | 01 |
| WA | 7141252 | 05 |
| Other Name | Type Code |
|---|---|
| Iverson Genetic Diagnostics Inc | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | IVERSON GENETIC DIAGNOSTICS, INC | 19805 North Creek Parkway, Bothell, WA 98011 |
| Street Address |
645 MEETING STREET |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780210674 | Samantha Barretta | Behavior Technician | 530 Meeting St, Apt 409, Charleston, SC 29403 | 2020-03-23 |
| 1114497435 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 10 Westedge St, Suite 100, Charleston, SC 29403 | 2018-11-29 |
| 1194266072 | Ashley Rogers Albrecht | Dentist | 29 Bee St, Fourth Floor, Charleston, SC 29403 | 2017-03-13 |
| 1427467307 | Valerie Nicole Garilas | Pharmacist | 1400 Woodruff Road, Greenville, SC 29403 | 2014-08-05 |
| 1467883645 | Disabilities Board of Charleston County | Case Management | 995 Morrison Drive, Suite 100, Charleston, SC 29403 | 2013-12-12 |
| 1326487588 | Tracy Jon Tipton | Urology | 125 Doughty St Ste 300, Charleston, SC 29403 | 2013-06-21 |
| 1205171964 | Brian Sherman | Psychologist | 26a Bee St., Charleston, SC 29403 | 2012-12-06 |
| 1710291455 | Linda Ramsey Bright | Clinical Nurse Specialist | 103 Bee Street, Charleston, SC 29403 | 2010-08-05 |
| 1598990442 | Colleen Lehn Degeorge | Social Worker | 198 Rutledge Avenue, Suite 8, Charleston, SC 29403 | 2009-05-21 |
| 1164618815 | Diane Andrews | Speech-Language Pathologist | Musc Speech Language Pathology, 169 Ashley Ave Msc 335, Charleston, SC 29403 | 2007-09-17 |
| Find all providers in zip 29403 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558976100 | Enmed Microanalytics, Inc | Clinical Medical Laboratory | 645 Meeting St Ste 2, Charleston, SC 29403-4277 | 2020-09-10 |
| 1831674084 | Appalachian Labs of Wv LLC | Clinical Medical Laboratory | 708 Bigley Ave., Ste. A, Charleston, WV 25302-3357 | 2018-10-03 |
| 1174009245 | Vikor Scientific, LLC | Clinical Medical Laboratory | 22 Westedge St., Suite 800, Charleston, SC 29403-2940 | 2018-07-12 |
| 1376081612 | Mountaineer Laboratories LLC | Clinical Medical Laboratory | 1337 Virginia St E, Charleston, WV 25301-3011 | 2017-02-07 |
| 1437605615 | Phi Life Sciences LLC | Clinical Medical Laboratory | 645 Meeting St, Suite 3, Charleston, SC 29403-4279 | 2016-08-29 |
| 1205933421 | Kanawha Surgicenter | Clinical Medical Laboratory | 4803 Maccorkle Ave Se, Charleston, WV 25304-1948 | 2006-09-20 |
| 1699873240 | Integrated Health Care Providers, Inc. | Clinical Medical Laboratory | 830 Pennsylvania Ave Ste 205, Charleston, WV 25302-3389 | 2006-09-20 |
| 1891770806 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 120 Hills Plz, Charleston, WV 25387-2438 | 2005-12-13 |
| 1184288623 | Msrc, LLC | Clinical Medical Laboratory | 102 Patrick Street Plz, Charleston, WV 25387-2444 | 2019-04-30 |
| 1194294587 | Msrc, LLC | Clinical Medical Laboratory | 102 Patrick Street Plz, Charleston, WV 25387-2444 | 2018-11-15 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29403 |
Please comment or provide details below to improve the information on IVERSON GENETIC DIAGNOSTICS, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.