Oakridge Clinical Lab LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

OAKRIDGE CLINICAL LAB LLC

Practice address

1000 NE 56TH St
Attn Business Office
Fort Lauderdale, FL 33334-4149

Phone

(954) 958-0606

Fax

(954) 116-0821

NPI assigned

Jan 23, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Fritz Phanord

Title

Manager Business Office

Phone

95495870606

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306990668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NE 56TH ST",
            "address_2": "ATTN BUSINESS OFFICE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333344149",
            "telephone_number": "954-958-0606",
            "fax_number": "954-116-0821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 NE 56TH ST",
            "address_2": "ATTN BUSINESS OFFICE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333344149",
            "telephone_number": "954-958-0606",
            "fax_number": "954-116-0821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKRIDGE CLINICAL LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PHANORD",
        "authorized_official_first_name": "FRITZ",
        "authorized_official_title_or_position": "MANAGER BUSINESS OFFICE",
        "authorized_official_telephone_number": "95495870606",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS PROVIDER ID",
            "identifier": "L9099",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Sue O'Neill, LMHC
• Robert O'Neill, R.PH.
• Susan Elizabeth O'Neill, MSN, FNP-BC
• Darby Oakes, DO, MPH
• Oakridge Ambulatory Surgery
• Oakridge Medical Group
• Oasis Living Quarters
• Celeste L Oatman, PS
• OB Hospitalist Group LLC
• OB Hospitalist Group LLC

• All providers in Fort Lauderdale, FL
• Clinical Medical Laboratory in Florida

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.