Monmouth Tissue Laboratory, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MONMOUTH TISSUE LABORATORY, LLC

Practice address

10 Industrial Way E
Suite 110
Eatontown, NJ 07724-3332

Phone

(732) 460-2838

NPI assigned

Jul 18, 2011

Organization subpart

No

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

Authorized official

Name

David Portman

Title

Owner

Phone

(732) 389-1531

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310947200000",
    "number": "1467740936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 HIGHWAY 35",
            "address_2": "SUITE 206",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241876",
            "telephone_number": "732-460-2838",
            "fax_number": "732-460-2843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 INDUSTRIAL WAY E",
            "address_2": "SUITE 110",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077243332",
            "telephone_number": "732-460-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONMOUTH TISSUE LABORATORY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-18",
        "last_updated": "2011-07-18",
        "status": "A",
        "authorized_official_last_name": "PORTMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-389-1531"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monmouth Digestive Health LLC
• Monmouth Mall Dental, PA
• Monmouth Medical Association PC
• Monmouth Pulmonary Consultants P a
• Monmouth Rejuvenation, LLC
• Nakita Moorer, LPN
• Colleen L. Morgan, MAOTR/L
• Gretchen Morgan, MSW, LCSW
• Sarah A Morris, MD
• Michelle Moss

• Clinical Medical Laboratory in Eatontown, NJ
• Providers in Eatontown, NJ by specialty
• Clinical Medical Laboratory in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.