NPIMap

Organization Active NPI

State of Alabama Department of Public Health

Doing business as Mobile Div - Bureau of Clinical Labs

  • Clinical Medical Laboratory
  • Mobile, AL
National Provider Identifier
1437294642
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
01D0641761 Issued in AL
Legal business name
STATE OF ALABAMA DEPARTMENT OF PUBLIC HEALTH
Doing business as
Mobile Div - Bureau of Clinical Labs
Practice address
757 Museum Dr
Mobile, AL 36608-1939
Phone
(251) 344-6049
NPI assigned
Feb 21, 2007
Last updated
Jan 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Authorized official

Name
Regina L Patterson
Title
Director of Health Systems
Phone
(334) 206-5061

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 01D0641761 AL Primary

Addresses

Primary practice location

757 Museum Dr
Mobile, AL 36608-1939

Mailing address

PO Box 1000
Prattville, AL 36067-9901

Other identifiers 1

IdentifierTypeStateIssuer
009910480MedicaidAL

Other names 1

  • Mobile Div - Bureau of Clinical Labs Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150815000013 AL Part B Supplier - Independent Clinical Laboratory 8022007970 Practice locations: Mobile, AL

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Lawrence County Health Dept Adult Immun1,340 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

20371 Clyde Mabry Dr
Athens, AL 35611
Phone (256) 230-0434

757 Museum Dr
Mobile, AL 36608
Phone (251) 344-6049

201 Monroe St
Montgomery, AL 36104
Phone (334) 206-5680

201 Monroe St
Ste 1100
Montgomery, AL 36104
Phone (334) 206-5677

201 Monroe St
Ste 1180
Montgomery, AL 36104
Phone (334) 206-5696

3060 Mobile Hwy
Montgomery, AL 36108
Phone (334) 293-6400

204 Legends Ct
Prattville, AL 36066
Phone (334) 290-6130

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Alabama Department of Public Health Home CareMontgomery, AL, CCN 017000 Home health agency Operational/Managerial Control Jul 1, 1966

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705449600000",
    "number": "1437294642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360679901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 MUSEUM DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366081939",
            "telephone_number": "251-344-6049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF ALABAMA DEPARTMENT OF PUBLIC HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "REGINA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF HEALTH SYSTEMS",
        "authorized_official_telephone_number": "334-206-5061"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AL",
            "license": "01D0641761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009910480",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mobile Div - Bureau of Clinical Labs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.