Mid Atlantic Laboratory Services, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MID ATLANTIC LABORATORY SERVICES, LLC

Practice address

1610 Forest Ave
Suite 114
Richmond, VA 23229-5009

Phone

(804) 445-2940

Fax

(804) 445-2930

NPI assigned

May 21, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Arden B. Bourgeois

Title

Managing Director/Pincipal

Phone

(804) 334-1130

Specialties & licenses 1

Addresses

Other names 1

• Midalabs Doing business as

Locations

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

{
    "created_epoch": "1274400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276646400000",
    "number": "1114246766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 FOREST AVE",
            "address_2": "SUITE 114",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232295009",
            "telephone_number": "804-445-2940",
            "fax_number": "804-445-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 FOREST AVE",
            "address_2": "SUITE 114",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232295009",
            "telephone_number": "804-445-2940",
            "fax_number": "804-445-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID ATLANTIC LABORATORY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-21",
        "last_updated": "2010-06-16",
        "status": "A",
        "authorized_official_last_name": "BOURGEOIS",
        "authorized_official_first_name": "ARDEN",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "MANAGING DIRECTOR/PINCIPAL",
        "authorized_official_telephone_number": "804-334-1130",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midalabs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katherine Anne Michos, PT, DPT
• Pamela A Mickell, MD
• Melody Mickens
• Ashley C Mickle, LCSW
• Shirley A Mickleberry
• Mid Atlantic Vascular Holding, LLC
• Mid-Atlantic Kidney Center
• Midatlantic Spine Specialists P C
• Middleton Gee Community Group Home, LLC
• Angela D Middleton, M.D.

• Clinical Medical Laboratory in Richmond, VA
• Providers in Richmond, VA by specialty
• Clinical Medical Laboratory in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; 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.