KC Pathology Laboratory LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

KC PATHOLOGY LABORATORY LLC

Practice address

44400 Van Dyke Ave Ste 102a
Sterling Heights, MI 48314-2370

Phone

(586) 262-4241

NPI assigned

Feb 24, 2023

Organization subpart

No

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

Authorized official

Name

Robert Mansi

Title

Operations Manager

Phone

(248) 818-4925

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Rafic Beydoun, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Detroit, MI
  • NPI 1831455138
  NPD

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

{
    "created_epoch": "1677196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745798400000",
    "number": "1174222491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44400 VAN DYKE AVE STE 102A",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483142370",
            "telephone_number": "586-262-4241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44400 VAN DYKE AVE STE 102A",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483142370",
            "telephone_number": "586-262-4241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KC PATHOLOGY LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-24",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A",
        "authorized_official_last_name": "MANSI",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "248-818-4925"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arsenia Kattula, PA-C
• Lana Kawa, MD
• Samer Y Kazziha, MD
• KB Family Home Care LLC
• KC Pathology Associates PLLC
• Chaitanya Deepthi Kedarisetti, PT
• Jason Keeler
• Dajanee Kelly
• Jennifer Kelly
• Michael Kelly

• Clinical Medical Laboratory in Sterling Heights, MI
• Providers in Sterling Heights, 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 Apr 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.