NPIMap

Organization Active NPI

Excellent Phlebotomy Lab Services LLC

Doing business as EP Lab Service

  • Clinical Medical Laboratory
  • Desoto, TX
National Provider Identifier
1437702867
Registry record updated Jul 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
EXCELLENT PHLEBOTOMY LAB SERVICES LLC
Doing business as
EP Lab Service
Practice address
1615 Osprey Dr Ste 107
Desoto, TX 75115-2427
Phone
(469) 930-5842
Fax
(866) 315-5210
NPI assigned
Jul 24, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2020

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

Authorized official

Name
Latrilla CasseyNPI 1962055012
Title
Owner
Phone
(405) 748-0207

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 246RP1900X
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

1615 Osprey Dr Ste 107
Desoto, TX 75115-2427

Mailing address

1615 Osprey Dr Ste 107
Desoto, TX 75115-2427
Phone (469) 930-5842

Other practice location 1

5500 E Loop 820 S Ste 200
Fort Worth, TX 76119-6566
Phone (405) 748-0207

Other names 1

  • EP Lab Service Doing business as

National Provider Directory

National Provider Directory

Locations

1615 Osprey Dr
#107
Desoto, TX 75115
Phone (469) 930-5842

5500 E Loop 820 S
Ste 200
Fort Worth, TX 76119
Phone (405) 748-0207

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595203200000",
    "number": "1437702867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 OSPREY DR STE 107",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152427",
            "telephone_number": "469-930-5842",
            "fax_number": "866-315-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 OSPREY DR STE 107",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152427",
            "telephone_number": "469-930-5842",
            "fax_number": "866-315-5210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5500 E Loop 820 S Ste 200",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761196566",
            "country_code": "US",
            "telephone_number": "405-748-0207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EXCELLENT PHLEBOTOMY LAB SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-24",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A",
        "authorized_official_last_name": "CASSEY",
        "authorized_official_first_name": "LATRILLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-748-0207"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EP Lab Service",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EP Lab Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Desoto, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; 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.