NPIMap

Organization Active NPI

Medstat Clinical Laboratory Services

  • Clinical Medical Laboratory
  • Wylie, TX
National Provider Identifier
1093848749
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
CLIA# 45D0986849 Issued in TX
Legal business name
MEDSTAT CLINICAL LABORATORY SERVICES
Practice address
1401 Quail Meadow Dr
Wylie, TX 75098-7974
Phone
(800) 808-6511
Fax
(800) 621-0883
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Authorized official

Name
Mr. Christopher R. Nall, EMT, PHLEBOTOMIST
Title
Laboratory Director-President
Phone
(800) 808-6511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X CLIA# 45D0986849 TX Primary

Addresses

Primary practice location

1401 Quail Meadow Dr
Wylie, TX 75098-7974

Mailing address

1401 Quail Meadow Dr
Wylie, TX 75098-7974
Phone (800) 808-6511

Other names 1

  • Medstat Mobile Lab Services Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1093848749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 QUAIL MEADOW DR",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750987974",
            "telephone_number": "800-808-6511",
            "fax_number": "800-621-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 QUAIL MEADOW DR",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750987974",
            "telephone_number": "800-808-6511",
            "fax_number": "800-621-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTAT CLINICAL LABORATORY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "NALL",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "LABORATORY DIRECTOR-PRESIDENT",
        "authorized_official_telephone_number": "800-808-6511",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "EMT, PHLEBOTOMIST"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TX",
            "license": "CLIA# 45D0986849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medstat Mobile Lab Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wylie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.