Skippack Clinical Lab

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

000421 Issued in PA

Legal business name

SKIPPACK CLINICAL LAB

Practice address

3887 Skippack Pike
Skippack, PA 19474-0817

Phone

(610) 584-1669

Fax

(610) 584-5188

NPI assigned

Dec 27, 2006

Last updated

Feb 27, 2012By 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

Mrs. Hasu B Amin, MS ASCP

Title

Lab Supervisor

Phone

(610) 584-1669

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Skippack Medical Laboratory Other name

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330300800000",
    "number": "1093870255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 817",
            "address_2": "3887 SKIPPACK PIKE",
            "city": "SKIPPACK",
            "state": "PA",
            "postal_code": "194740817",
            "telephone_number": "610-584-1669",
            "fax_number": "610-584-5188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3887 SKIPPACK PIKE",
            "city": "SKIPPACK",
            "state": "PA",
            "postal_code": "194740817",
            "telephone_number": "610-584-1669",
            "fax_number": "610-584-5188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIPPACK CLINICAL LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2012-02-27",
        "status": "A",
        "authorized_official_last_name": "AMIN",
        "authorized_official_first_name": "HASU",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "LAB SUPERVISOR",
        "authorized_official_telephone_number": "610-584-1669",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS ASCP"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PA",
            "license": "SK301440",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PA",
            "license": "000983405",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PA",
            "license": "000421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE BLUE SHIELD",
            "identifier": "000421",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000983405",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Skippack Medical Laboratory",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Clinical Medical Laboratory in Skippack, PA
• Providers in Skippack, PA by specialty
• Clinical Medical Laboratory in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2012; 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.