Ziva Medical Lab Mo LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ZIVA MEDICAL LAB MO LLC

Practice address

620 E Monroe St
Mexico, MO 65265-2919

Phone

(573) 570-3516

Fax

(573) 675-6040

NPI assigned

Sep 12, 2023

Organization subpart

No

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

Authorized official

Name

Amanda Shurtz

Title

Ceo

Phone

(573) 570-3555

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694476800000",
    "number": "1336926419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 197",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087010197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 E MONROE ST",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652652919",
            "telephone_number": "573-570-3516",
            "fax_number": "573-675-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZIVA MEDICAL LAB MO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-12",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A",
        "authorized_official_last_name": "SHURTZ",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-570-3555"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ziva Medical Audrain LLC
• Ziva Medical Center LLC (Zivamed Laboratory)
• Ziva Medical Center LLC (Zivamed Idtf)
• Ziva Medical Center LLC (Zivamed ASC)
• Ziva Medical Imaging LLC
• Ziva Medical Primary Care LLC
• Ziva Medical Specialty Clinic LLC

• Clinical Medical Laboratory in Mexico, MO
• Providers in Mexico, MO by specialty
• Clinical Medical Laboratory in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; 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.