Mylab Diagnostics

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

LC1286813 Issued in MO

Legal business name

MYLAB DIAGNOSTICS

Practice address

448 Sovereign CT Ste B
Ballwin, MO 63011-4445

Phone

(636) 373-1349

NPI assigned

Jan 29, 2013

Organization subpart

No

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

Authorized official

Name

Basit Ali Syed

Title

Owner

Phone

(636) 253-6682

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1359417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361664000000",
    "number": "1063750842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "448 SOVEREIGN CT STE B",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "448 SOVEREIGN CT STE B",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114445",
            "telephone_number": "636-373-1349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYLAB DIAGNOSTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-29",
        "last_updated": "2013-02-24",
        "status": "A",
        "authorized_official_last_name": "SYED",
        "authorized_official_first_name": "BASIT",
        "authorized_official_middle_name": "ALI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-253-6682"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MO",
            "license": "LC1286813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Charles Mulawa, PA-C
• Elizabeth Courtny Munger, R.N.
• Molly Paskal Murphy
• Timothy P. Murphy, M.D.
• Gina Marie Mydlo, DPT
• Julie Nack, PHARMD
• Hunt S Nagy, PT, DPT
• Allison Nappe, PT, DPT
• Amanda Nash
• Maryam Nasir

• Clinical Medical Laboratory in Ballwin, MO
• Providers in Ballwin, MO by specialty
• Clinical Medical Laboratory in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2013; 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.