NPIMap

Organization Active NPI

Medlab Inc

  • Clinical Medical Laboratory
  • Golden Valley, MN
National Provider Identifier
1164993523
Registry record updated Dec 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
MEDLAB INC
Practice address
800 Boone Ave N
Golden Valley, MN 55427-4468
Phone
(763) 267-6654
NPI assigned
Dec 11, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2018

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

Authorized official

Name
Mr. Matthew WaffensmithNPI 1275856353
Title
Director of Operations
Phone
(218) 851-0213

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

800 Boone Ave N
Golden Valley, MN 55427-4468

Mailing address

800 Boone Ave N
Golden Valley, MN 55427-4468
Phone (763) 267-6654

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1544486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544486400000",
    "number": "1164993523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BOONE AVE N",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274468",
            "telephone_number": "763-267-6654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BOONE AVE N",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274468",
            "telephone_number": "763-267-6654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDLAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-11",
        "last_updated": "2018-12-11",
        "status": "A",
        "authorized_official_last_name": "WAFFENSMITH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "218-851-0213",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

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