Magnolia Diagnostic Laboratories, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MAGNOLIA DIAGNOSTIC LABORATORIES, LLC

Practice address

2868 Acton Rd Ste 205
Vestavia, AL 35243-2502

Phone

(844) 364-9969

Fax

(866) 702-0880

NPI assigned

Jan 9, 2020

Organization subpart

No

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

Authorized official

Name

Jeslyn Metcalf

Title

Billing Operations Manager

Phone

(205) 379-6075

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chad E Austin, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Birmingham, AL
  • NPI 1659581551
  NPD (past)

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

{
    "created_epoch": "1578528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578528000000",
    "number": "1386284156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2868 ACTON RD STE 205",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352432502",
            "telephone_number": "205-379-6075",
            "fax_number": "866-702-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2868 ACTON RD STE 205",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352432502",
            "telephone_number": "844-364-9969",
            "fax_number": "866-702-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA DIAGNOSTIC LABORATORIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-09",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A",
        "authorized_official_last_name": "METCALF",
        "authorized_official_first_name": "JESLYN",
        "authorized_official_title_or_position": "BILLING OPERATIONS MANAGER",
        "authorized_official_telephone_number": "205-379-6075"
    },
    "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 Vestavia, AL
• Providers in Vestavia, AL by specialty
• Clinical Medical Laboratory in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; 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.