Prime Laboratory, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PRIME LABORATORY, LLC

Practice address

28266 Franklin Rd
Suite a
Southfield, MI 48034-1659

Phone

(855) 996-2666

Fax

(888) 679-1304

NPI assigned

Feb 9, 2017

Organization subpart

No

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

Authorized official

Name

Mahnaz Jaffry

Title

Managing Member

Phone

(855) 996-2666

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486598400000",
    "number": "1023556016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28266 FRANKLIN RD",
            "address_2": "SUITE A",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341659",
            "telephone_number": "855-996-2666",
            "fax_number": "888-679-1304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28266 FRANKLIN RD",
            "address_2": "SUITE A",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341659",
            "telephone_number": "855-996-2666",
            "fax_number": "888-679-1304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME LABORATORY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-09",
        "last_updated": "2017-02-09",
        "status": "A",
        "authorized_official_last_name": "JAFFRY",
        "authorized_official_first_name": "MAHNAZ",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "855-996-2666"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prime Mobile Care Incorporated
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• Primemart Pharmacy, LLC
• Primesource of Michigan LLC

• Clinical Medical Laboratory in Southfield, MI
• Providers in Southfield, MI by specialty
• Clinical Medical Laboratory in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; 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.