B & L Medical Laboratory

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

207ZP0102X Issued in GA

Legal business name

B & L MEDICAL LABORATORY

Practice address

149 Sycamore St
Decatur, GA 30030-3338

Phone

(404) 371-8419

Fax

(404) 371-8314

NPI assigned

Jan 24, 2008

Last updated

Jan 24, 2008By 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

Dr. Luis Aurelio Rodriguez Sr., M.D.

Title

President

Phone

(404) 371-8419

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201132800000",
    "number": "1457538134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 SYCAMORE ST",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303338",
            "telephone_number": "404-371-8419",
            "fax_number": "404-371-8314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 SYCAMORE ST",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303338",
            "telephone_number": "404-371-8419",
            "fax_number": "404-371-8314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B & L MEDICAL LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-24",
        "last_updated": "2008-01-24",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "AURELIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-371-8419",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "GA",
            "license": "207ZP0102X",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MO",
            "license": "207ZP0102X",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00081573D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "265908119A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Decatur, GA
• Providers in Decatur, GA by specialty
• Clinical Medical Laboratory in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2008; 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.