Five Star Laboratory Service LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

FIVE STAR LABORATORY SERVICE LLC

Practice address

4131 University Blvd S Ste 12
Jacksonville, FL 32216-4352

Phone

(904) 673-8416

NPI assigned

Aug 23, 2022

Last updated

Feb 24, 2025By 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

Melonie MillerNPI 1083295984

Title

Owner

Phone

(904) 673-8416

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.

• Melonie Denise Miller

  • Homemaker
  • Jacksonville, FL
  • NPI 1083295984
  Authorized official Same address or phone

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1174242259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 UNIVERSITY BLVD S STE 12",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164352",
            "telephone_number": "904-673-8416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 UNIVERSITY BLVD S STE 12",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164352",
            "telephone_number": "904-673-8416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR LABORATORY SERVICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-23",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MELONIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-673-8416"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Jacksonville, FL
• Providers in Jacksonville, 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 Feb 24, 2025; 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.