Martell Diagnostic Laboratories, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MARTELL DIAGNOSTIC LABORATORIES, INC.

Practice address

301 Carlson Pkwy Ste 103
Minnetonka, MN 55305-5358

Phone

(715) 273-4104

NPI assigned

Oct 21, 2011

Last updated

Oct 21, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Franklin Pass

Title

Chairman, Ceo

Phone

(715) 273-4104

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1319155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319155200000",
    "number": "1073898086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 CARLSON PKWY STE 103",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553055358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 CARLSON PKWY STE 103",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553055358",
            "telephone_number": "715-273-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTELL DIAGNOSTIC LABORATORIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-21",
        "last_updated": "2011-10-21",
        "status": "A",
        "authorized_official_last_name": "PASS",
        "authorized_official_first_name": "FRANKLIN",
        "authorized_official_title_or_position": "CHAIRMAN, CEO",
        "authorized_official_telephone_number": "715-273-4104",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn Amanda Marquis, M.S.P.T.
• Fredricka Marsh, DNP, FNP-BC
• Margot Dearborn Marsh, LICSW
• Robert Marsh, MD
• Tracey T Marshall-Best, FNP-C
• Nicole Anne Martens, CNP
• David Charles Martin, M.D.
• Erin Martin, ARNP
• Laura Mae Martin, RN MSN FNP-C
• Kimberly Marie Martinczak, OT (TEMP LICENSE)

• Clinical Medical Laboratory in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Clinical Medical Laboratory in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; 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.