University Suburban Health Center

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CLIA36D0337191

Legal business name

UNIVERSITY SUBURBAN HEALTH CENTER

Practice address

1611 South Green Road
Suite 011
South Euclid, OH 44121-4129

Phone

(216) 382-8920

Fax

(216) 382-1684

NPI assigned

May 17, 2006

Organization subpart

No

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

Authorized official

Name

Charles R Abbey

Title

Executive Director

Phone

(216) 297-2032

Specialties & licenses 2

Addresses

Other identifiers 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": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315958400000",
    "number": "1255383097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 SOUTH GREEN ROAD",
            "address_2": "SUITE 009",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441214129",
            "telephone_number": "216-382-8920",
            "fax_number": "216-382-1684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 SOUTH GREEN ROAD",
            "address_2": "SUITE 011",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441214129",
            "telephone_number": "216-382-8920",
            "fax_number": "216-382-1684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY SUBURBAN HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2011-09-14",
        "status": "A",
        "authorized_official_last_name": "ABBEY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "216-297-2032"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OH",
            "license": "36D0337191CLIA",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": "CLIA36D0337191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0316643",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• University Primary Care Practices Inc
• University Primary Care Practices Inc
• University Suburban Gynecologists, Inc
• University Suburban Gynecology 2LLC
• University Suburban Health Center
• University Suburban Health Center
• Cashane Bettye Vance
• Michael Patrick Varley, M.D.
• Carmi Vassar
• Lily Grace Veeravalli

• Clinical Medical Laboratory in South Euclid, OH
• Providers in South Euclid, OH by specialty
• Clinical Medical Laboratory in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.