Organization Active NPI

Professional Clinical Laboratory, Inc.

  • Clinical Medical Laboratory
  • Carrollton, TX
National Provider Identifier
1437344546
Registry record updated Dec 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
PROFESSIONAL CLINICAL LABORATORY, INC.
Doing business as
ProLab
Practice address
2329 Parker Rd
Carrollton, TX 75010-4713
Phone
(866) 776-5221
Fax
(817) 568-1960
NPI assigned
Sep 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2009

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

Authorized official

Name
Holly R Shields
Title
Coo
Phone
(866) 776-5221

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

2329 Parker Rd
Carrollton, TX 75010-4713

Mailing address

3020 Wichita CT
Fort Worth, TX 76140-1710
Phone (866) 776-5221

Other identifiers 3

IdentifierTypeStateIssuer
10007948OtherTXAMERIGROUP
CL5046OtherTXBLUE CROSS BLUE SHIELD
690008760OtherTXRAILROAD MEDICARE

Other names 1

  • ProLab Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259798400000",
    "number": "1437344546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 WICHITA CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761401710",
            "telephone_number": "866-776-5221",
            "fax_number": "817-568-1960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2329 PARKER RD",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750104713",
            "telephone_number": "866-776-5221",
            "fax_number": "817-568-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL CLINICAL LABORATORY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2009-12-03",
        "status": "A",
        "authorized_official_last_name": "SHIELDS",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "866-776-5221"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10007948",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "CL5046",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "690008760",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProLab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carrollton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2009; 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.