St. Thomas Clinical Reference Laboratory
Organization Active NPI Clinical Medical Laboratory · St Thomas, VI
NPI 1407301401 · NPPES record last updated Dec 9, 2024
Key facts
- NPI
- 1407301401
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Medical Laboratory 291U00000X
- License
- 1348871L (VI)
- Legal business name
- ST. THOMAS CLINICAL REFERENCE LABORATORY
- Practice address
- Medical Complex
Suite No. 9 St Thomas
St Thomas, VI 00802-5735 - Phone
- (340) 774-6256
- NPI assigned
- Aug 19, 2016
- Organization subpart
- No
Authorized official
- Name
- Carlos A Gonzalez
- Title
- Presidente
- Phone
- (787) 246-4698
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170313001354 | VI | Part B Supplier - Independent Clinical Laboratory | 2062796055 | Practice locations: St Thomas, VI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 1348871L | VI | Yes |
Addresses
Primary practice location
Medical Complex
Suite No. 9 St Thomas
St Thomas, VI 00802-5735
Mailing address
Medical Complex
Suite No. 3 St Thomas
St Thomas, VI 00802-5735
Other providers in St Thomas, VI
- St Thomas Radiology Associates LLC
- St. Clair Institute, Inc.
- St. Croix Vision Center
- St. Croix Vision Center
- St. Croix Vision Center
- St. Thomas Community Health Outpatient Clinic
- Cathryn Stauffer
- Janessa Lynn Steil
- Kevin Phillip Stewart
- Wendy Wilson Stiles
All providers in St Thomas, VI · Clinical Medical Laboratory in U.S. Virgin Islands
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.