Med Diagnostic Laboratory Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MED DIAGNOSTIC LABORATORY INC

Practice address

499 NW 70TH Ave
Plantation, FL 33317-7500

Phone

(754) 800-1426

NPI assigned

Mar 28, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Gandhi Jacques

Title

Owner

Phone

(954) 369-7253

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andre T Wharton

  • Clinical Medical Laboratory
  • Plantation, FL
  • NPI 1578267191
  NPD (past)

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697587200000",
    "number": "1063116606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 NW 70TH AVE",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333177500",
            "telephone_number": "754-800-1426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 NW 70TH AVE",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333177500",
            "telephone_number": "754-800-1426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED DIAGNOSTIC LABORATORY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A",
        "authorized_official_last_name": "JACQUES",
        "authorized_official_first_name": "GANDHI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-369-7253",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Plantation, FL
• Providers in Plantation, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.