GENESIS MEDICAL DIAGNOSTICS PLLC
NPI 1245803402
Clinical Medical Laboratory in San Antonio, TX

NPI Status: Active since July 23, 2021

Contact Information

4195 NACO PERRIN BLVD
SAN ANTONIO, TX
ZIP 78217
Phone: (210) 276-0045
Fax: (832) 565-1921

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  • Organization
  • Clinical Medical Laboratory
  • CLIA Number: 45D0501119
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 12-18-2026

About GENESIS MEDICAL DIAGNOSTICS PLLC

This page provides the complete NPI Profile along with additional information for Genesis Medical Diagnostics Pllc, a provider established in San Antonio, Texas operating as a Clinical Medical Laboratory. The healthcare provider is registered in the NPI registry with number 1245803402 assigned on July 2021. The practitioner's primary taxonomy code is 291U00000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Dr. Ewan D. Johnson Md, Phd (Ceo/founder)

NPI
1245803402
Provider Name
GENESIS MEDICAL DIAGNOSTICS PLLC
Entity Type
Organization
Location Address
4195 NACO PERRIN BLVD SAN ANTONIO, TX 78217
Location Phone
(210) 276-0045
Location Fax
(832) 565-1921
Mailing Address
14090 FM 2920 RD STE 345G TOMBALL, TX 77377
Mailing Phone
(281) 415-6687
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-23-2021
Last Update Date
09-16-2021
Code Navigator

Establishments like Genesis Medical Diagnostics Pllc are healthcare facilities that may perform a wide range of laboratory procedures, assisted by doctors and medical technologists. Laboratories can be categorized according to their function as common diagnostic labs or specialty labs that conduct specialized or confirmatory tests. Different clinical laboratories could specialize in clinical chemistry, clinical microbiology, hematology, serology, clinical microscopy, cytopathology, molecular biology, or public health. Please inquire directly with this provider to confirm their test menu.

Clinical labs in the U.S. that perform human testing are regulated by the Centers for Medicare & Medicaid Services (CMS) through the Clinical Laboratory Improvement Amendments (CLIA) program. The purpose of the CLIA program is to guarantee the quality of laboratory testing. This provider has a CLIA number assigned, and undergoes regular inspections to ensure compliance and quality.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinical Medical Laboratory

Taxonomy Code
291U00000X
Type
Laboratories
Taxonomy Description
(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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. EWAN D. JOHNSON MD, PHD

Authorized Official Title
CEO/FOUNDER
Authorized Official Phone
(281) 415-6687

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
45D2216609OTHER (01)TXCLIA NUMBER

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
45D0501119
Facility Type
Physician Office
Certificate Effective Date
December 19, 2024
Certificate Expiration Date
December 18, 2026
Laboratory Director
JUANITA SPRUTE
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Genesis Medical Diagnostics Pllc in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1245803402, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
4
Doubled → 8
Pos 4
5
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
0
Unchanged
Pos 7
3
Doubled → 6
Pos 8
4
Unchanged
Pos 9
0
Doubled → 0
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 8 → 16 → 7 3 → 6 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 8 + 5 + 1 + 6 + 0 + 6 + 4 + 0 + 24 = 58

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1245803402.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1245803402, enumerated as an "organization" on July 23, 2021.

The provider is located at 4195 NACO PERRIN BLVD SAN ANTONIO, TX 78217 and the phone number is (210) 276-0045.

Clinical Medical Laboratory with taxonomy code 291U00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.