Jace Laboratories and Screening LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

JACE LABORATORIES AND SCREENING LLC

Doing business as

JACE Laboratories and Screening LLC

Practice address

9951 Atlantic Blvd Ste 434
Jacksonville, FL 32225-6553

Phone

(833) 434-5223

Fax

(888) 686-6271

NPI assigned

Aug 9, 2021

Organization subpart

No

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

Authorized official

Name

Ima Latoya WallaceNPI 1053063834

Title

Executive Director

Phone

(833) 434-5223

Specialties & licenses 1

Addresses

Other names 1

• JACE Laboratories and Screening LLC Doing business as

Electronic endpoints 1

Locations

Practitioners 1

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

• Ima Latoya Wallace

  • Other Technician
  • Jacksonville, FL
  • NPI 1053063834
  NPD Authorized official

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628467200000",
    "number": "1225703648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9951 ATLANTIC BLVD STE 434",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322256553",
            "telephone_number": "833-434-5223",
            "fax_number": "888-686-6271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9951 ATLANTIC BLVD STE 434",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322256553",
            "telephone_number": "833-434-5223",
            "fax_number": "888-686-6271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACE LABORATORIES AND SCREENING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-09",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "IMA",
        "authorized_official_middle_name": "LATOYA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "833-434-5223"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.jacelaboratories.com/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9951 Atlantic Blvd Ste 434",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322256553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "JACE Laboratories and Screening LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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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 Aug 9, 2021; 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.