Organization Active NPI

Prosperity Labs LLC

  • Clinical Medical Laboratory
  • Fairfax, VA
National Provider Identifier
1336918283
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
PROSPERITY LABS LLC
Practice address
10617 Jones St Ste 101a
Fairfax, VA 22030-7526
Phone
(443) 848-1021
NPI assigned
Dec 20, 2023
Last updated
Jul 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Authorized official

Name
Katharina Thiara
Title
Ceo
Phone
(443) 848-1021

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

10617 Jones St Ste 101a
Fairfax, VA 22030-7526

Mailing address

10617 Jones St Ste 101a
Fairfax, VA 22030-7526
Phone (443) 848-1021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240412003279 DC Part B Supplier - Independent Clinical Laboratory 5395184139 Practice locations: Centreville, VA

National Provider Directory

National Provider Directory

Locations

10617 Jones St
Ste 101A
Fairfax, VA 22030
Phone (443) 848-1021

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1703030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753228800000",
    "number": "1336918283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10617 JONES ST STE 101A",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220307526",
            "telephone_number": "443-848-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10617 JONES ST STE 101A",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220307526",
            "telephone_number": "443-848-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPERITY LABS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-20",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A",
        "authorized_official_last_name": "THIARA",
        "authorized_official_first_name": "KATHARINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-848-1021"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.