C19 Labs LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

C19 LABS LLC

Practice address

881 Corporate Dr
Lexington, KY 40503-2748

Phone

(609) 977-0604

NPI assigned

Oct 6, 2020

Organization subpart

No

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

Authorized official

Name

Andrew Taylor Bright, PHD

Title

President

Phone

(609) 977-0604

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• C19 Labs LLC

  • Clinical Medical Laboratory
  • Lexington, KY
  • NPI 1952169021

  O20211111001187

  Same enrollment
• C19 Labs LLC

  • Clinical Medical Laboratory
  • Lexington, KY
  • NPI 1992490320

  O20211111001187

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

C19 Labs LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• C19 Labs LLC

  • Clinical Medical Laboratory
  • Lexington, KY
  • NPI 1952169021
  NPD tax ID
• C19 Labs LLC

  • Clinical Medical Laboratory
  • Lexington, KY
  • NPI 1992490320
  NPD tax ID

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

{
    "created_epoch": "1601942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690848000000",
    "number": "1437756137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "838 E HIGH ST # 202",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405022107",
            "telephone_number": "609-977-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "881 CORPORATE DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405032748",
            "telephone_number": "609-977-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C19 LABS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-06",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A",
        "authorized_official_last_name": "BRIGHT",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "TAYLOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "609-977-0604",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010936",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100870290",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raymond J Byron Jr., DMD
• Samuel Hugh Byron, DO
• C. Christopher. Allen, PH.D., P.S.C.
• C. Craig Stafford, MD PSC
• C'S New Beginnings
• C19 Labs LLC
• C19 Labs LLC
• Lidia Lucia Caballero
• Ramon Luis Caballero, MD
• Barbara TS Caceres-Lund, CADC, ICADC

• Clinical Medical Laboratory in Lexington, KY
• Providers in Lexington, KY by specialty
• Clinical Medical Laboratory in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.