Independent Laboratory Medicine LLC

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

INDEPENDENT LABORATORY MEDICINE LLC

Practice address

1729 Alan Broke Drive
Mt. Pleasant, SC 29466-9214

Phone

(520) 405-8649

NPI assigned

Jul 17, 2024

Organization subpart

No

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

Authorized official

Name

Lauren Le Bleau

Title

Owner

Phone

(520) 405-8649

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1721174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1043058654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 ALAN BROKE DRIVE",
            "city": "MT. PLEASANT",
            "state": "SC",
            "postal_code": "29466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 ALAN BROKE DRIVE",
            "city": "MT. PLEASANT",
            "state": "SC",
            "postal_code": "294669214",
            "telephone_number": "520-405-8649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT LABORATORY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-17",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-10",
        "status": "A",
        "authorized_official_last_name": "LE BLEAU",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-405-8649"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anatomic Pathology & Clinical Pathology Physician in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Anatomic Pathology & Clinical Pathology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.