Pediatric Lab Services Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PEDIATRIC LAB SERVICES INC

Practice address

12200 Middle Set Rd Ste 100
Eden Prairie, MN 55344-5420

Phone

(952) 943-8200

Fax

(952) 943-8206

NPI assigned

Dec 10, 2010

Organization subpart

No

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

Authorized official

Name

Mr. John Beattie

Title

Owner

Phone

(612) 672-3662

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1291939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291939200000",
    "number": "1255634440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 MIDDLE SET RD STE 100",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445420",
            "telephone_number": "952-943-8200",
            "fax_number": "952-943-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 MIDDLE SET RD STE 100",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445420",
            "telephone_number": "952-943-8200",
            "fax_number": "952-943-8206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC LAB SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-10",
        "last_updated": "2010-12-10",
        "status": "A",
        "authorized_official_last_name": "BEATTIE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-672-3662",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PDG, P.a.
• Brandy Pearrow, APN
• Theresa Pecha
• Amy Pedersen
• Marilou Pederson, C.P.N.P.
• Linda Ruth Peitzman, M.D.
• Marisa Lynn Pender, DNP, FNP-C
• Joanne Penn, M.T.
• Pennebaker Clinic of Chiropractic,LLC
• Bryan Peralta Garces, DPT, PT

• Clinical Medical Laboratory in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Clinical Medical Laboratory in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2010; 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.