Suburban Medical Laboratory, Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

36D0339673 Issued in OH

Legal business name

SUBURBAN MEDICAL LABORATORY, INC

Doing business as

MEDLAB

Practice address

6800 Virginia Manor Rd
Beltsville, MD 20705-4200

Phone

(216) 409-7394

NPI assigned

Sep 29, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Donald Hoskins

Title

Director, Billing

Phone

51237527300

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• MEDLAB Doing business as

Locations

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

{
    "created_epoch": "1317254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329782400000",
    "number": "1417231226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 VIRGINIA MANOR RD",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207054200",
            "telephone_number": "216-409-7394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 VIRGINIA MANOR RD",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207054200",
            "telephone_number": "216-409-7394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN MEDICAL LABORATORY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-29",
        "last_updated": "2012-02-21",
        "status": "A",
        "authorized_official_last_name": "HOSKINS",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "DIRECTOR, BILLING",
        "authorized_official_telephone_number": "51237527300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OH",
            "license": "36D0339673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "36D0339673",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP",
            "identifier": "00",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0288004",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDLAB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in Beltsville, MD
• Providers in Beltsville, MD by specialty
• Clinical Medical Laboratory in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; 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.