Meridian Clinical Laboratory, Corp

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

800015640 Issued in FL

Legal business name

MERIDIAN CLINICAL LABORATORY, CORP

Practice address

300 SW 107TH Ave
Suite 209
Miami, FL 33174-3600

Phone

(305) 554-9790

Fax

(305) 228-8387

NPI assigned

Aug 8, 2006

Organization subpart

Yes

Parent organization

BIO-REFERENCE LABORATORIES, INCAs reported in NPPES

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

Authorized official

Name

Mr. Warren W Erdmann

Title

Coo; Executive VP

Phone

(201) 791-2600

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Bio Reference Lab Inc

Locations

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523577600000",
    "number": "1124038930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 EDWARD H ROSS DR",
            "address_2": "SUITE 209",
            "city": "ELMWOOD PARK",
            "state": "NJ",
            "postal_code": "074073118",
            "telephone_number": "201-791-2600",
            "fax_number": "201-791-1941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SW 107TH AVE",
            "address_2": "SUITE 209",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331743600",
            "telephone_number": "305-554-9790",
            "fax_number": "305-228-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN CLINICAL LABORATORY, CORP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BIO-REFERENCE LABORATORIES, INC",
        "enumeration_date": "2006-08-08",
        "last_updated": "2018-04-13",
        "status": "A",
        "authorized_official_last_name": "ERDMANN",
        "authorized_official_first_name": "WARREN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "COO; EXECUTIVE VP",
        "authorized_official_telephone_number": "201-791-2600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "800015640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030671100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jose Yacko Merida Fuentes
• Irina Lillian Merida Quintana, LMT
• Alfredo Merida, RBT
• Diana R Merida
• Sirena Nicole Merida, BS
• Meridian Health Center Inc
• Meridian Medical Group LLC
• Kristi Martina Merinkers-Parchment, OTR/L
• Leslieme.55 Merino Alvarez
• Merino Medical LLC

• Clinical Medical Laboratory in Miami, FL
• Providers in Miami, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; 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.