Intracellular Diagnostics, Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

05D0643971 Issued in OR

Legal business name

INTRACELLULAR DIAGNOSTICS, INC

Practice address

945 Town Centre Dr
Suite a
Medford, OR 97504-6190

Phone

(541) 245-3212

NPI assigned

Jan 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Burton B Silver, PH.D

Title

Laboratory Director

Phone

(541) 245-3212

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402444800000",
    "number": "1043366933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 TOWN CENTRE DR",
            "address_2": "SUITE A",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046190",
            "telephone_number": "541-245-3212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 TOWN CENTRE DR",
            "address_2": "SUITE A",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046190",
            "telephone_number": "541-245-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTRACELLULAR DIAGNOSTICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2014-06-11",
        "status": "A",
        "authorized_official_last_name": "SILVER",
        "authorized_official_first_name": "BURTON",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "LABORATORY DIRECTOR",
        "authorized_official_telephone_number": "541-245-3212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OR",
            "license": "05D0643971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA OUT OF STATE",
            "identifier": "COS00004338",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA NUMBER",
            "identifier": "05D0643971",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D0643971",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Medford, OR
• Providers in Medford, OR by specialty
• Clinical Medical Laboratory in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2014; 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.