NPIMap

Organization Active NPI

Suburban Medical Laboratory

  • Clinical Medical Laboratory
  • Bettsville, MD
National Provider Identifier
1447535901
Registry record updated Oct 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
36D0904468 Issued in OH
Legal business name
SUBURBAN MEDICAL LABORATORY
Practice address
6800 Virginia Manor Rd
Bettsville, MD 20705
Phone
(216) 409-7394
NPI assigned
Oct 17, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2011

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

Authorized official

Name
Dr. Gary Milburn, PHD
Title
Coo
Phone
(513) 752-7300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 36D0904468 OH Primary

Addresses

Primary practice location

6800 Virginia Manor Rd
Bettsville, MD 20705

Mailing address

671 Ohio Pike, #K
Cincinnati, OH 45245
Phone (513) 752-7300

Other names 1

  • MEDLAB 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": "1318809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318809600000",
    "number": "1447535901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "671 OHIO PIKE, #K",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45245",
            "telephone_number": "513-752-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 VIRGINIA MANOR RD",
            "city": "BETTSVILLE",
            "state": "MD",
            "postal_code": "20705",
            "telephone_number": "216-409-7394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN MEDICAL LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-17",
        "last_updated": "2011-10-17",
        "status": "A",
        "authorized_official_last_name": "MILBURN",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "513-752-7300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OH",
            "license": "36D0904468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDLAB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; 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.