United Medical Lab LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

UNITED MEDICAL LAB LLC

Practice address

3201 Easton Ave
Chattanooga, TN 37415-4715

Phone

(270) 683-7991

NPI assigned

Oct 28, 2020

Organization subpart

No

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

Authorized official

Name

Jacob Shah

Title

Director

Phone

(270) 683-7991

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1316547474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 EASTON AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374154715",
            "telephone_number": "270-683-7991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 EASTON AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374154715",
            "telephone_number": "270-683-7991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED MEDICAL LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-28",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "270-683-7991"
    },
    "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 Oct 28, 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.