Mna Lab, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MNA LAB, LLC

Practice address

24555 Southfield Rd
Suite 190
Southfield, MI 48075-2738

Phone

(248) 234-8739

NPI assigned

Mar 17, 2015

Last updated

Mar 17, 2015By 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

Dr. Thomas Giancarlo, D.O.NPI 1780627018

Title

Managing Member

Phone

(586) 445-9900

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas Giancarlo, DO

  • Neurology Physician
  • Clinton Township, MI
  • NPI 1780627018
  NPD Authorized official

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

{
    "created_epoch": "1426550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426550400000",
    "number": "1164815924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34025 HARPER AVE",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480353737",
            "telephone_number": "586-445-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24555 SOUTHFIELD RD",
            "address_2": "SUITE 190",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752738",
            "telephone_number": "248-234-8739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MNA LAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-17",
        "last_updated": "2015-03-17",
        "status": "A",
        "authorized_official_last_name": "GIANCARLO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "586-445-9900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "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 Southfield, MI
• Providers in Southfield, MI by specialty
• Clinical Medical Laboratory in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; 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.