Active NPI
Centrex Clinical Laboratories Inc
- Clinical Medical Laboratory
- Utica, NY
National Provider Identifier
1184621716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- 22053227A020
- Legal business name
- CENTREX CLINICAL LABORATORIES INC
- Practice address
- 1656 Champlin Ave
Utica, NY 13502-4830 - Phone
- (315) 797-0790
- NPI assigned
- Jun 28, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kimberly Williams
- Title
- VP
- Phone
- (800) 222-7566
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 22053227A020 | NY | Primary |
Addresses
Primary practice location
1656 Champlin Ave
Utica, NY 13502-4830
Mailing address
28 Campion Rd
New Hartford, NY 13413-1602
Phone (315) 797-0791
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00478524 | Medicaid | NY |
National Provider Directory
National Provider DirectoryMember of 2
Organizations this organization is a member of, according to the National Provider Directory.
-
- Clinical Medical Laboratory
- Cromwell, CT
- NPI 1700517984
Member Of
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119916800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1392940800000",
"number": "1184621716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 CAMPION RD",
"city": "NEW HARTFORD",
"state": "NY",
"postal_code": "134131602",
"telephone_number": "315-797-0791",
"fax_number": "315-797-1849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1656 CHAMPLIN AVE",
"city": "UTICA",
"state": "NY",
"postal_code": "135024830",
"telephone_number": "315-797-0790"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CENTREX CLINICAL LABORATORIES INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-06-28",
"last_updated": "2014-02-21",
"status": "A",
"authorized_official_last_name": "WILLIAMS",
"authorized_official_first_name": "KIMBERLY",
"authorized_official_title_or_position": "VP",
"authorized_official_telephone_number": "800-222-7566"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "NY",
"license": "22053227A020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00478524",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Utica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.