Shades of Life Labs LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SHADES OF LIFE LABS LLC

Practice address

138 S Rosemont Rd Ste 210
Virginia Beach, VA 23452-4336

Phone

(757) 431-3000

Fax

(757) 210-9481

NPI assigned

Jun 8, 2021

Organization subpart

No

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

Authorized official

Name

Dionne Gibbs, RN

Title

Lab Director

Phone

(757) 472-5434

Specialties & licenses 1

Addresses

Other names 1

• Shades of Life Labs, LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628812800000",
    "number": "1144897133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 S ROSEMONT RD STE 210",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234524336",
            "telephone_number": "757-672-3507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 S ROSEMONT RD STE 210",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234524336",
            "telephone_number": "757-431-3000",
            "fax_number": "757-210-9481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADES OF LIFE LABS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A",
        "authorized_official_last_name": "GIBBS",
        "authorized_official_first_name": "DIONNE",
        "authorized_official_title_or_position": "LAB DIRECTOR",
        "authorized_official_telephone_number": "757-472-5434",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shades of Life Labs, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shades of Life Labs, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aliyah Shabazz
• Barbara Ford Shabazz, PSY.D.
• Paige Irene Shabro, FNP-BC
• Adriana Shade, OD
• Shades of Life Home Care Services,LLC
• Shades of Life LLC
• Tracey J Shaffer, OD
• Keyuri S Shah, PT
• Kiritkumar Shah, MD
• Mehul Shah, RPH

• Clinical Medical Laboratory in Virginia Beach, VA
• Providers in Virginia Beach, 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 Aug 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.