Organization Active NPI

Salvuslabs LLC

  • Clinical Medical Laboratory
  • Marietta, GA
National Provider Identifier
1083018295
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
11D2084569 Issued in GA
Legal business name
SALVUSLABS LLC
Practice address
200 Cobb Pkwy N Ste 124
Marietta, GA 30062-3538
Phone
(678) 738-1999
Fax
(678) 236-0916
NPI assigned
Oct 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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

Authorized official

Name
Charlotte A Hymel
Title
Ceo
Phone
(678) 738-1999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 11D2084569 GA Primary

Addresses

Primary practice location

200 Cobb Pkwy N Ste 124
Marietta, GA 30062-3538

Mailing address

200 Cobb Pkwy N Ste 124
Marietta, GA 30062-3538
Phone (678) 738-1999

Other identifiers 1

IdentifierTypeStateIssuer
11D2084569OtherGACLIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150304002366 GA Part B Supplier - Independent Clinical Laboratory 5991021222 Practice locations: Marietta, GA

National Provider Directory

National Provider Directory

Locations

200 Cobb Pkwy N
Ste 100
Marietta, GA 30062

200 Cobb Pkwy N
Ste 124
Marietta, GA 30062
Phone (678) 738-1999

NPI Registry JSON

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594857600000",
    "number": "1083018295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 COBB PKWY N STE 124",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300623538",
            "telephone_number": "678-738-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 COBB PKWY N STE 124",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300623538",
            "telephone_number": "678-738-1999",
            "fax_number": "678-236-0916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALVUSLABS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-17",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A",
        "authorized_official_last_name": "HYMEL",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-738-1999"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "GA",
            "license": "11D2084569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "11D2084569",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.