Suburban Medical Laboratory, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

36D0339673 Issued in OH

Legal business name

SUBURBAN MEDICAL LABORATORY, INC.

Doing business as

Medlab

Practice address

3575 Forest Lake Dr
#500
Uniontown, OH 44685

Phone

(330) 628-7500

Fax

(300) 628-7599

NPI assigned

Mar 11, 2006

Last updated

Oct 15, 2009By 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

Ms. Cindy Smotherman

Title

Director, Billing

Phone

(513) 201-1117

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Medlab Doing business as

Locations

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

{
    "created_epoch": "1142035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255564800000",
    "number": "1346218674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3575 FOREST LAKE DR",
            "address_2": "#500",
            "city": "UNIONTOWN",
            "state": "OH",
            "postal_code": "44685",
            "telephone_number": "330-628-7500",
            "fax_number": "300-628-7599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 FOREST LAKE DR",
            "address_2": "#500",
            "city": "UNIONTOWN",
            "state": "OH",
            "postal_code": "44685",
            "telephone_number": "330-628-7500",
            "fax_number": "300-628-7599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN MEDICAL LABORATORY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-11",
        "last_updated": "2009-10-15",
        "status": "A",
        "authorized_official_last_name": "SMOTHERMAN",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "DIRECTOR, BILLING",
        "authorized_official_telephone_number": "513-201-1117",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OH",
            "license": "36D0339673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0288004",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "36D0339673",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medlab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in Uniontown, OH
• Providers in Uniontown, 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 Oct 15, 2009; 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.