Sovereign Laboratory Services, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SOVEREIGN LABORATORY SERVICES, LLC

Practice address

680 Kinderkamack Rd Ste 101B
Oradell, NJ 07649-1600

Phone

(201) 994-4069

NPI assigned

Aug 23, 2010

Organization subpart

No

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

Authorized official

Name

Dr. John H. HajjarNPI 1104894435

Title

MD

Phone

(201) 994-4069

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Sovereign Medical Group LLC

  • Urology Physician
  • Oradell, NJ
  • NPI 1710282082

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John H. Hajjar, MD

  • Urology Physician
  • Jersey City, NJ
  • NPI 1104894435
  NPD (past) Authorized official

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

{
    "created_epoch": "1282521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1356657787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 KINDERKAMACK RD",
            "address_2": "SUITE 300 3RD FLOOR",
            "city": "ORADELL",
            "state": "NJ",
            "postal_code": "076491600",
            "telephone_number": "201-994-4069",
            "fax_number": "201-301-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 KINDERKAMACK RD STE 101B",
            "city": "ORADELL",
            "state": "NJ",
            "postal_code": "076491600",
            "telephone_number": "201-994-4069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN LABORATORY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-23",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "HAJJAR",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "201-994-4069",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Oradell, NJ
• Providers in Oradell, NJ by specialty
• Clinical Medical Laboratory in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.