Orange Grove Labs LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ORANGE GROVE LABS LLC

Practice address

1325 S Killian Dr
Unit 3a
Lake Park, FL 33403-1965

Phone

(561) 567-0063

Fax

(561) 847-4466

NPI assigned

Sep 17, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Louis Devaleix

Title

Managing Member

Phone

(561) 567-0063

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482969600000",
    "number": "1376912642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 S KILLIAN DR",
            "address_2": "UNIT 3A",
            "city": "LAKE PARK",
            "state": "FL",
            "postal_code": "334031965",
            "telephone_number": "561-567-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 S KILLIAN DR",
            "address_2": "UNIT 3A",
            "city": "LAKE PARK",
            "state": "FL",
            "postal_code": "334031965",
            "telephone_number": "561-567-0063",
            "fax_number": "561-847-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGE GROVE LABS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-17",
        "last_updated": "2016-12-29",
        "status": "A",
        "authorized_official_last_name": "DEVALEIX",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "561-567-0063",
        "authorized_official_name_prefix": "Mr."
    },
    "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 Lake Park, FL
• Providers in Lake Park, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; 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.