Centennial Laboratory, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

CENTENNIAL LABORATORY, LLC

Practice address

3525 W Freddy Gonzalez Dr
Suite B
Edinburg, TX 78539-8544

Phone

(956) 381-0440

Fax

(956) 381-0483

NPI assigned

Jul 21, 2009

Organization subpart

No

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

Authorized official

Name

Dr. William K Dablah Jr., M.D.

Title

Ceo/Owner

Phone

(404) 822-6845

Specialties & licenses 1

Addresses

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.

• Alberto Patricio Gonzalez, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Weslaco, TX
  • NPI 1689776304
  NPD (past)

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

{
    "created_epoch": "1248134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268611200000",
    "number": "1346470663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 W FREDDY GONZALEZ DR",
            "address_2": "SUITE B",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785398544",
            "telephone_number": "956-381-0440",
            "fax_number": "956-381-0483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 W FREDDY GONZALEZ DR",
            "address_2": "SUITE B",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785398544",
            "telephone_number": "956-381-0440",
            "fax_number": "956-381-0483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTENNIAL LABORATORY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-21",
        "last_updated": "2010-03-15",
        "status": "A",
        "authorized_official_last_name": "DABLAH",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "404-822-6845",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Edinburg, TX
• Providers in Edinburg, TX by specialty
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2010; 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.