Medical Laboratory Services of Nevada, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MEDICAL LABORATORY SERVICES OF NEVADA, LLC

Practice address

2725 S Jones Blvd Ste 107
Las Vegas, NV 89146-5605

Phone

(702) 384-2238

NPI assigned

Jul 9, 2020

Last updated

Jul 19, 2022By 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

Ancy Tom, APRNNPI 1669840203

Title

/Owner/Manager

Phone

(702) 384-2238

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ancy Tom, NP

  • Family Nurse Practitioner
  • Las Vegas, NV
  • NPI 1669840203
  NPD Authorized official

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658188800000",
    "number": "1083232789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 S JONES BLVD STE 104",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 S JONES BLVD STE 107",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465605",
            "telephone_number": "702-384-2238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL LABORATORY SERVICES OF NEVADA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-09",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A",
        "authorized_official_last_name": "TOM",
        "authorized_official_first_name": "ANCY",
        "authorized_official_title_or_position": "/OWNER/MANAGER",
        "authorized_official_telephone_number": "702-384-2238",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "desktop",
            "affiliation": "N",
            "address_1": "2725 S Jones Blvd Ste 101",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891465605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Medical Laboratory in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Clinical Medical Laboratory in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.