NPIMap

Organization Active NPI

Neogenomics Laboratories Inc

  • Clinical Medical Laboratory
  • Pasadena, CA
National Provider Identifier
1346645512
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
NEOGENOMICS LABORATORIES INC
Practice address
840 Cameron Dr
Pasadena, CA 91106
Phone
(866) 776-5907
Fax
(888) 443-4153
NPI assigned
Oct 29, 2014
Last updated
Aug 26, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
NEOGENOMICS LABORATORIES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Authorized official

Name
Kathryn B McKenzie
Title
VP & Principal Accounting Officer
Phone
(866) 776-5907

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary
Specialist 174400000X NU

Addresses

Primary practice location

840 Cameron Dr
Pasadena, CA 91106

Mailing address

31 Columbia
Aliso Viejo, CA 92656-1460
Phone (866) 776-5907

Other identifiers 2

IdentifierTypeStateIssuer
05D2083526OtherCACLIA
05D2083526OtherMEDICARE CLIA

Other names 1

  • Clarient Diagnostic Services, Inc Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071116000642 CA Part B Supplier - Independent Clinical Laboratory 7113011172 10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aliso Viejo, CA; Carlsbad, CA; Fresno, CA; San Diego, CA; Sierra Madre, CA

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Neogenomics Inc

Locations

101 Theory
Ste 150
Irvine, CA 92617
Phone (949) 443-3355

21031 Ventura Blvd
Ste 700
Woodland Hls, CA 91364
Phone (888) 690-0043

2575 W Bellfort Ave
Ste 2001
Houston, TX 77054
Phone (888) 690-0043

NPI Registry JSON

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

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566777600000",
    "number": "1346645512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 COLUMBIA",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926561460",
            "telephone_number": "866-776-5907",
            "fax_number": "888-443-4153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 CAMERON DR",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "91106",
            "telephone_number": "866-776-5907",
            "fax_number": "888-443-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEOGENOMICS LABORATORIES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEOGENOMICS LABORATORIES INC",
        "enumeration_date": "2014-10-29",
        "last_updated": "2019-08-26",
        "status": "A",
        "authorized_official_last_name": "MCKENZIE",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "VP & PRINCIPAL ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "866-776-5907"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D2083526",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CLIA",
            "identifier": "05D2083526",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarient Diagnostic Services, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Clarient Diagnostic Services, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; 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.