Provider Demographics
NPI:1033880224
Name:NEXX GEN LABORATORIES
Entity type:Organization
Organization Name:NEXX GEN LABORATORIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNGER-MANSOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-256-0229
Mailing Address - Street 1:10461 AUSTIN DR
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91978-1519
Mailing Address - Country:US
Mailing Address - Phone:619-357-7974
Mailing Address - Fax:619-660-6970
Practice Address - Street 1:10461 AUSTIN DR
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91978-1519
Practice Address - Country:US
Practice Address - Phone:858-256-0229
Practice Address - Fax:619-660-6970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-27
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory