Clio Laboratories, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

CLIO LABORATORIES, LLC

Practice address

1130 Hurricane Shoals Rd NE Ste 2300
Lawrenceville, GA 30043-4871

Phone

(470) 395-7370

Fax

(470) 395-7371

NPI assigned

Dec 10, 2015

Organization subpart

No

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

Authorized official

Name

Arafat Mahmud Diab

Title

Owner

Phone

(334) 233-1607

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568851200000",
    "number": "1013382431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 HURRICANE SHOALS RD NE STE 2300",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300434871",
            "telephone_number": "470-395-7370",
            "fax_number": "470-395-7371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 HURRICANE SHOALS RD NE STE 2300",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300434871",
            "telephone_number": "470-395-7370",
            "fax_number": "470-395-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIO LABORATORIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-10",
        "last_updated": "2019-09-19",
        "status": "A",
        "authorized_official_last_name": "DIAB",
        "authorized_official_first_name": "ARAFAT",
        "authorized_official_middle_name": "MAHMUD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-233-1607"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "11D2108137",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Clinical Medical Laboratory in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; 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.