NPIMap

Organization Active NPI

Mesa Clinical Laboratories, PC

  • Clinical Medical Laboratory
  • Portland, OR
National Provider Identifier
1013169499
Registry record updated May 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
38D1062236 Issued in OR
Legal business name
MESA CLINICAL LABORATORIES, PC
Practice address
10300 NE Hancock St
Portland, OR 97220-3831
Phone
(503) 257-5567
NPI assigned
Oct 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Michael V Mesa, D.O.NPI 1184744351
Title
President/Owner
Phone
(503) 257-5568

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 38D1062236 OR Primary

Addresses

Primary practice location

10300 NE Hancock St
Portland, OR 97220-3831

Mailing address

10300 NE Hancock St
Portland, OR 97220-3831
Phone (503) 257-5567

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241654400000",
    "number": "1013169499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10300 NE HANCOCK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972203831",
            "telephone_number": "503-257-5567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 NE HANCOCK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972203831",
            "telephone_number": "503-257-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA CLINICAL LABORATORIES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-16",
        "last_updated": "2009-05-07",
        "status": "A",
        "authorized_official_last_name": "MESA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "503-257-5568",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OR",
            "license": "38D1062236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.