Innovative Diagnostics Laboratory LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

INNOVATIVE DIAGNOSTICS LABORATORY LLC

Practice address

7 Lincoln Hwy Ste 101a
Edison, NJ 08820-3965

Phone

(908) 315-0333

Fax

(908) 315-0125

NPI assigned

Apr 19, 2023

Last updated

Apr 19, 2023By 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

Mona Tuccillo

Title

Lab Manager

Phone

(908) 315-0333

Specialties & licenses 1

Addresses

Practitioners 5

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.

• Rodine Charles Borja, PT, DPT

  • Physical Therapist
  • Edison, NJ
  • NPI 1225637895
  NPD
• Emily Rose Faller, PT, DPT

  • Physical Therapist
  • Belmar, NJ
  • NPI 1386255990
  NPD
• Sierra Grace Wells, MS, OTR/L

  • Occupational Therapist
  • Edison, NJ
  • NPI 1215548839
  NPD
• Jeral Bailey

  • Speech-Language Pathologist
  • Edison, NJ
  • NPI 1255867206
  NPD (past)
• Yealisha A Kamara, DPT

  • Physical Therapist
  • Edison, NJ
  • NPI 1154804680
  NPD (past)

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

{
    "created_epoch": "1681862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681862400000",
    "number": "1184311367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 LINCOLN HWY STE 101A",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203965",
            "telephone_number": "908-315-0333",
            "fax_number": "908-315-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 LINCOLN HWY STE 101A",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203965",
            "telephone_number": "908-315-0333",
            "fax_number": "908-315-0125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE DIAGNOSTICS LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-19",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A",
        "authorized_official_last_name": "TUCCILLO",
        "authorized_official_first_name": "MONA",
        "authorized_official_title_or_position": "LAB MANAGER",
        "authorized_official_telephone_number": "908-315-0333"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Infinite Endodontics North Jersey
• Infinity Orthopedics, L.LC.
• Inman Dental Care PC
• Inner-Peace Psychiatry LLC
• Innercore
• Innovative Physical Therapy and Fitness Center Inc
• Innovative Rehabilitation Center (Innovative Physical Therapy)
• Innovative Urology Associates P.a.
• Innovative Urology P.a.
• Insightful Care Solutions

• Clinical Medical Laboratory in Edison, NJ
• Providers in Edison, NJ by specialty
• Clinical Medical Laboratory in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.