Medical Laboratory Specialty, Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

03D2120368

Legal business name

MEDICAL LABORATORY SPECIALTY, INC

Practice address

3636 St
Kingman, AZ 86409

Phone

(928) 757-3636

NPI assigned

Jan 10, 2017

Last updated

Jan 10, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jahan Ferdous

Title

Director

Phone

(480) 703-4227

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.

• Rustom Ali, PHD

  • Nutrition Education Nutritionist
  • Lake Havasu City, AZ
  • NPI 1790190155
  NPD

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

{
    "created_epoch": "1484006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484006400000",
    "number": "1437695731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 W COLGATE DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831753",
            "telephone_number": "480-703-4227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 ST",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "86409",
            "telephone_number": "928-757-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL LABORATORY SPECIALTY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-10",
        "last_updated": "2017-01-10",
        "status": "A",
        "authorized_official_last_name": "FERDOUS",
        "authorized_official_first_name": "JAHAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "480-703-4227"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": "03D2120368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn McLaughlin, M.D.
• Lindsay McMeins
• Sarah Elizabeth McPhillips, LPC
• Colleen Mary McWeeney, FNP
• Taelor Mealey, LMT
• Lorena Ruth Meier, R.D.
• Stacey Lee Meier, FNP-C
• Clark E Melstrom
• Xochitl A. Mendez, D.O.
• Mentally Ill Kids in Distress

• Clinical Medical Laboratory in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Clinical Medical Laboratory in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; 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.