8 Mile Lab, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

8 MILE LAB, LLC

Practice address

24525 Southfield Rd
Suite 207
Southfield, MI 48075-2740

Phone

(248) 234-8679

NPI assigned

Mar 16, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Keith Evans

Title

Managing Member

Phone

(270) 570-1075

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426464000000",
    "number": "1275926289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 ALLEN ST",
            "address_2": "SUITE 203",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423033025",
            "telephone_number": "270-570-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24525 SOUTHFIELD RD",
            "address_2": "SUITE 207",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752740",
            "telephone_number": "248-234-8679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "8 MILE LAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-16",
        "last_updated": "2015-03-16",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "270-570-1075",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "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 Mar 16, 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.