Mineola Clinical Laboratory, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MINEOLA CLINICAL LABORATORY, LLC

Practice address

174 Mineola Blvd
Mineola, NY 11501-2513

Phone

(305) 575-4181

Fax

(201) 791-1941

NPI assigned

Mar 1, 2019

Last updated

Jul 15, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

OPKO HEALTH, INC.As reported in NPPES

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

Authorized official

Name

Jane Pine Wood

Title

Chief Legal Officer

Phone

(201) 791-2600

Specialties & licenses 1

Addresses

Part of

Opko Health Inc

Locations

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

{
    "created_epoch": "1551398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1366909921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 EDWARD H ROSS DR",
            "city": "ELMWOOD PARK",
            "state": "NJ",
            "postal_code": "074073118",
            "telephone_number": "201-791-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 MINEOLA BLVD",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012513",
            "telephone_number": "305-575-4181",
            "fax_number": "201-791-1941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINEOLA CLINICAL LABORATORY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OPKO HEALTH, INC.",
        "enumeration_date": "2019-03-01",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-14",
        "status": "A",
        "authorized_official_last_name": "PINE WOOD",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "CHIEF LEGAL OFFICER",
        "authorized_official_telephone_number": "201-791-2600"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Mineola, NY
• Providers in Mineola, NY by specialty
• Clinical Medical Laboratory in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.