My Clinical Lab Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MY CLINICAL LAB INC

Practice address

15481 SW 12TH St Ste 303
Sunrise, FL 33326-1993

Phone

(954) 530-8460

NPI assigned

Jun 28, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Juan Mesa

Title

President

Phone

(954) 530-8460

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Locations

Practitioners 1

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

• Aitor Lartitegui

  • Clinical Laboratory Director (Non-physician)
  • Sunrise, FL
  • NPI 1407315575
  NPD (past)

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

{
    "created_epoch": "1561680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561680000000",
    "number": "1386205474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15481 SW 12TH ST STE 303",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333261993",
            "telephone_number": "954-530-8460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15481 SW 12TH ST STE 303",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333261993",
            "telephone_number": "954-530-8460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY CLINICAL LAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-28",
        "last_updated": "2019-06-28",
        "status": "A",
        "authorized_official_last_name": "MESA",
        "authorized_official_first_name": "JUAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-530-8460",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John S Murdock
• Symantha Murdock
• Elizabeth Murias
• Brendan Murphy, M.S., BCBA
• Michael Francis Murphy, M.D.
• Thippeswamy Mydur, MD
• Gregory Myer, M.S.
• Sarah Adrian Myer, DC
• Charles L. Myers, MD
• Marie M. Myers, CRNA

• Clinical Medical Laboratory in Sunrise, FL
• Providers in Sunrise, 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 Jun 28, 2019; 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.