Elite Biomedical Lab Service

Primary specialty

Phlebotomy TechnicianTaxonomy code 246RP1900X

Legal business name

ELITE BIOMEDICAL LAB SERVICE

Practice address

15202 NW 147TH Dr Ste 600
Alachua, FL 32615-5333

Phone

(386) 588-3230

Fax

(888) 480-7977

NPI assigned

Jul 20, 2021

Organization subpart

No

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

Authorized official

Name

Marjillian Williams, BS,MT

Title

President

Phone

(386) 965-0313

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626739200000",
    "number": "1376116111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15202 NW 147TH DR STE 600",
            "city": "ALACHUA",
            "state": "FL",
            "postal_code": "326155333",
            "telephone_number": "386-588-3230",
            "fax_number": "888-480-7977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15202 NW 147TH DR STE 600",
            "city": "ALACHUA",
            "state": "FL",
            "postal_code": "326155333",
            "telephone_number": "386-588-3230",
            "fax_number": "888-480-7977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE BIOMEDICAL LAB SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MARJILLIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-965-0313",
        "authorized_official_credential": "BS,MT"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "10D2166575",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.elitelabservice.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "15202 NW 147th Dr Ste 600",
            "city": "Alachua",
            "state": "FL",
            "country_code": "US",
            "postal_code": "326155333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Phlebotomy Technician in Alachua, FL
• Providers in Alachua, FL by specialty
• Phlebotomy Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.