Avellino Lab USA, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

05D2048075 Issued in CA

Legal business name

AVELLINO LAB USA, INC.

Practice address

1505 Adams Dr
Suite B2
Menlo Park, CA 94025-1450

Phone

(650) 396-3741

NPI assigned

Dec 21, 2015

Last updated

Dec 21, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Scott Korney

Title

Chief Operating Officer

Phone

(650) 396-3741

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1450656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450656000000",
    "number": "1265897078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 ADAMS DR",
            "address_2": "SUITE B2",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940251450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 ADAMS DR",
            "address_2": "SUITE B2",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940251450",
            "telephone_number": "650-396-3741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVELLINO LAB USA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-21",
        "last_updated": "2015-12-21",
        "status": "A",
        "authorized_official_last_name": "KORNEY",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "650-396-3741",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "05D2048075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Menlo Park, CA
• Providers in Menlo Park, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2015; 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.