Organization Active NPI

Lab One of Ohio Inc

  • Clinical Medical Laboratory
  • Mansfield, OH
National Provider Identifier
1023306263
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
LAB ONE OF OHIO INC
Practice address
770 Balgreen Dr
Mansfield, OH 44906-4106
Phone
(419) 283-0714
NPI assigned
Jul 20, 2011
Organization subpart
Yes
Parent organization
QUEST DIAGNOSTICS INCORPORATEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

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

Authorized official

Name
Gerald Scott Cartier
Title
VP of Revenue Services
Phone
(484) 676-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

770 Balgreen Dr
Mansfield, OH 44906-4106

Mailing address

1001 Adams Ave Mrgov
2ND Floor
Norristown, PA 19403-2429
Phone (484) 676-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040202000813 OH Part B Supplier - Independent Clinical Laboratory 0749183010 7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cincinnati, OH

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0962642Advanced Dermatology of NC Ohio Inc770 Balgreen Drive Suite 201, Mansfield, OH 44906ComplianceFeb 13, 2028

National Provider Directory

National Provider Directory
Part of
Questdiagnost Ic Inc

NPI Registry JSON

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350345600000",
    "number": "1023306263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 ADAMS AVE MRGOV",
            "address_2": "2ND FLOOR",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194032429",
            "telephone_number": "484-676-7000",
            "fax_number": "484-676-5309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 BALGREEN DR",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449064106",
            "telephone_number": "419-283-0714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAB ONE OF OHIO INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUEST DIAGNOSTICS INCORPORATED",
        "enumeration_date": "2011-07-20",
        "last_updated": "2012-10-16",
        "status": "A",
        "authorized_official_last_name": "CARTIER",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "VP OF REVENUE SERVICES",
        "authorized_official_telephone_number": "484-676-7000"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.