Center for Molecular Cancer Diagnostics, Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

36D2061372 Issued in OH

Legal business name

CENTER FOR MOLECULAR CANCER DIAGNOSTICS, INC

Doing business as

Core Bio Labs

Practice address

7956 Tyler Blvd
Mentor, OH 44060-4806

Phone

(330) 405-2623

NPI assigned

Dec 10, 2013

Last updated

May 26, 2023By 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

Dr. Yuan Shan, M.D.

Title

Medical Director

Phone

(317) 695-8485

Specialties & licenses 1

Addresses

Other names 1

• Core Bio Labs Doing business as

Medicare fee-for-service enrollment

Enrolled in OH, IL2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Center for Molecular Cancer Diagnostics, Inc

  dba CoreBioLabs

  • Clinical Medical Laboratory
  • Broadview, IL
  • NPI 1134808033

  4183853468

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Center for Molecular Cancer Diagnostics, Inc

  dba CoreBioLabs

  • Clinical Medical Laboratory
  • Broadview, IL
  • NPI 1134808033

  O20230330002367

  Same enrollment

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Liming Wang

  • Clinical Laboratory Director (Non-physician)
  • Twinsburg, OH
  • NPI 1962833558
  NPD

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685059200000",
    "number": "1316378789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7956 TYLER BLVD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604806",
            "telephone_number": "330-405-2623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7956 TYLER BLVD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604806",
            "telephone_number": "330-405-2623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 W Roosevelt Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Broadview",
            "state": "IL",
            "postal_code": "601553869",
            "country_code": "US",
            "telephone_number": "330-405-2623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTER FOR MOLECULAR CANCER DIAGNOSTICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-10",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A",
        "authorized_official_last_name": "SHAN",
        "authorized_official_first_name": "YUAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "317-695-8485",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OH",
            "license": "36D2061372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Core Bio Labs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michelle Ann Cawley, NP-C
• Holly Joy Cayia, CT
• Richard J Cederlund
• Center for Advanced Vein Care LLC
• Center for Dialysis Care Home Care, LTD. (CDC Home Care Mentor)
• Jacqueline Macy Cerar, D.D.S.
• Laura Anne Cernosky I, LISW-S
• Norman J Cerny Jr., LSW
• Stephanie M Cerula, LPCC
• Francesca Cerutti

• Clinical Medical Laboratory in Mentor, OH
• Providers in Mentor, OH by specialty
• Clinical Medical Laboratory in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2023; 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.