Meadowlands Diagnostics LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MEADOWLANDS DIAGNOSTICS LLC

Practice address

177 Valley Blvd FL 2
Wood Ridge, NJ 07075-2011

Phone

(201) 347-6779

Fax

(201) 347-6788

NPI assigned

Oct 5, 2020

Last updated

Mar 11, 2021By 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

Mr. Reginald Samuels

Title

Chief Executive Officer

Phone

(973) 868-4750

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615420800000",
    "number": "1114524071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KNUTSEN DR",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522161",
            "telephone_number": "973-868-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 VALLEY BLVD FL 2",
            "city": "WOOD RIDGE",
            "state": "NJ",
            "postal_code": "070752011",
            "telephone_number": "201-347-6779",
            "fax_number": "201-347-6788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEADOWLANDS DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-05",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A",
        "authorized_official_last_name": "SAMUELS",
        "authorized_official_first_name": "REGINALD",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "973-868-4750",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Wood Ridge, NJ
• Providers in Wood Ridge, NJ by specialty
• Clinical Medical Laboratory in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; 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.