Realtox Labs, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

21D2077230 Issued in MD

Legal business name

REALTOX LABS, LLC

Practice address

200 Business Center Dr
Reisterstown, MD 21136-1230

Phone

(410) 833-3025

Fax

(410) 833-3158

NPI assigned

Oct 13, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Joshua Gochnauer

Title

Owner

Phone

(410) 833-3025

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Practitioners 1

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

• Daniel James Gardner, MPT

  • Physical Therapist
  • Frederick, MD
  • NPI 1457408940
  NPD

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

{
    "created_epoch": "1413158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413158400000",
    "number": "1235533779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BUSINESS CENTER DR",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211361230",
            "telephone_number": "410-833-3025",
            "fax_number": "410-833-3158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BUSINESS CENTER DR",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211361230",
            "telephone_number": "410-833-3025",
            "fax_number": "410-833-3158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REALTOX LABS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-13",
        "last_updated": "2014-10-13",
        "status": "A",
        "authorized_official_last_name": "GOCHNAUER",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-833-3025",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MD",
            "license": "21D2077230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "21D2077230",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Quality Assured Staffing, LLC Dba: Qasolutions
• Yuliya Mira Raboi, MS
• Sam Alexander Rakhman, LMT
• Darlene L. Reaka Israel, MSN, CRNP
• Real Diagnostics, LLC
• Rebecca H Radcliffe Counseling
• Rediclinic of MD, LLC
• Reisterstown Ambulatory Surgical Center
• Tatyana Reznikov, MD
• Karen Lynn Richards, LCSW-C

• Clinical Medical Laboratory in Reisterstown, MD
• Providers in Reisterstown, MD by specialty
• Clinical Medical Laboratory in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.