Stadia Labs Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

STADIA LABS INC

Practice address

1200 NW 78TH Ave Ste 111
Doral, FL 33126-1816

Phone

(786) 773-5421

NPI assigned

Oct 19, 2023

Organization subpart

No

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

Authorized official

Name

Cheveral Deacon

Title

Manager

Phone

(305) 491-3809

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1697673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704499200000",
    "number": "1134901598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 NW 78TH AVE STE 111",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331261816",
            "telephone_number": "786-773-5421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NW 78TH AVE STE 111",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331261816",
            "telephone_number": "786-773-5421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STADIA LABS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-19",
        "last_updated": "2024-01-06",
        "certification_date": "2024-01-06",
        "status": "A",
        "authorized_official_last_name": "DEACON",
        "authorized_official_first_name": "CHEVERAL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "305-491-3809"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Doral, FL
• Providers in Doral, 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 Jan 6, 2024; 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.