St. Jude Laboratories LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ST. JUDE LABORATORIES LLC

Practice address

8950 Route 108 Ste 121
Columbia, MD 21045-2150

Phone

(410) 862-8162

Fax

(410) 630-7474

NPI assigned

Mar 8, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Bose KalampanayilNPI 1205319159

Title

Owner

Phone

(410) 884-4120

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 1

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

• Bose Kalampanayil, PHD

  • Chemical Pathology Physician
  • Silver Spring, MD
  • NPI 1205319159
  NPD Authorized official

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

{
    "created_epoch": "1552003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756425600000",
    "number": "1083172043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 ROUTE 108 STE 121",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452150",
            "telephone_number": "410-862-8162",
            "fax_number": "410-630-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8950 ROUTE 108 STE 121",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452150",
            "telephone_number": "410-862-8162",
            "fax_number": "410-630-7474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9017 Mendenhall Ct Ste D",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210454732",
            "country_code": "US",
            "telephone_number": "410-862-8162",
            "fax_number": "410-630-7474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST. JUDE LABORATORIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-08",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A",
        "authorized_official_last_name": "KALAMPANAYIL",
        "authorized_official_first_name": "BOSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-884-4120",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NA",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St. Agnes Healthcare, Inc.
• St. Agnes Healthcare, Inc.
• St. Agnes Healthcare, Inc.
• St. Agnes Healthcare, Inc.
• St. Agnes Healthcare, Inc.
• Donna Lapierre St.Hilaire, RN
• Carolyn Jessica Stabile, MS, OTR/L
• Diane E Stabler, M.D.
• Tiffany Stach, RN
• Thomas Wood Stacy, PHD

• Clinical Medical Laboratory in Columbia, MD
• Providers in Columbia, MD by specialty
• Clinical Medical Laboratory in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2025; 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.