Excell Clinical Laboratory, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

31D1048389 Issued in NJ

Legal business name

EXCELL CLINICAL LABORATORY, INC.

Practice address

95 Dermody St
Cranford, NJ 07016-3215

Phone

(732) 287-5115

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Marina Belotserkovsky

Title

President

Phone

(732) 287-5115

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621296000000",
    "number": "1215038310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 DERMODY ST",
            "city": "CRANFORD",
            "state": "NJ",
            "postal_code": "070163215",
            "telephone_number": "732-287-5115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 DERMODY ST",
            "city": "CRANFORD",
            "state": "NJ",
            "postal_code": "070163215",
            "telephone_number": "732-287-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELL CLINICAL LABORATORY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A",
        "authorized_official_last_name": "BELOTSERKOVSKY",
        "authorized_official_first_name": "MARINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-287-5115",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MD",
            "license": "18404",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NJ",
            "license": "31D1048389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Evangelista, DPT
• Jhade Evans, DPT
• Evervital Care LLC
• Excel Care Inc (Cranford Health and Extended Care Center)
• Excel-Care, Inc (Birchwood Square at Cranford Health)
• Eye Institute of Central New Jersey, PC
• Jordan S Faiman, MA, LPC
• Family Based Strategies
• Family Resource Center
• Benjamin Fand, MD

• Clinical Medical Laboratory in Cranford, NJ
• Providers in Cranford, 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 May 18, 2021; 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.