Med Health Clinical Lab LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MED HEALTH CLINICAL LAB LLC

Practice address

1414 NW 107TH Ave
Suite 305
Doral, FL 33172-2732

Phone

(305) 592-2888

Fax

(305) 592-2666

NPI assigned

Jul 28, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Grethel M Rabassa

Title

Manager Owner

Phone

(305) 592-2888

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 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": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275547192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 NW 107TH AVE",
            "address_2": "SUITE 305",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331722732",
            "telephone_number": "305-592-2888",
            "fax_number": "305-592-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 NW 107TH AVE",
            "address_2": "SUITE 305",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331722732",
            "telephone_number": "305-592-2888",
            "fax_number": "305-592-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED HEALTH CLINICAL LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RABASSA",
        "authorized_official_first_name": "GRETHEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER OWNER",
        "authorized_official_telephone_number": "305-592-2888",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.