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General NPI Number Information
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NPI Number | 1174419758
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Entity Type | Organization
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Legal Business Name | SYNERGENIX DIAGNOSTICS
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 9001 WOODYARD RD STE C
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City | CLINTON
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State | MD
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Zip | 20735-4264
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Country | US
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Telephone | 202-607-3875
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Fax |
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Provider Business Mailing Address
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Address Line | 9001 WOODYARD RD STE C
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City | CLINTON
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State | MD
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Zip | 20735-4264
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Country | US
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Telephone | 202-607-3875
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOEY JENKINS
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Credential |
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Telephone | 202-607-3875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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