Physicians Toxicology Laboratory, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PHYSICIANS TOXICOLOGY LABORATORY, LLC

Practice address

4433 Manchester Rd.
Kalamazoo, MI 49001

Phone

(239) 213-1600

Fax

(239) 213-1940

NPI assigned

Dec 20, 2010

Organization subpart

No

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

Authorized official

Name

Matthew Ryan Lund

Title

President

Phone

(239) 269-0035

Specialties & licenses 1

Addresses

Other names 1

• Affirmatox, LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Physicians Toxicology Laboratory, LLC

  • Clinical Medical Laboratory
  • Tampa, FL
  • NPI 1639508757

  7911182415

  Same PAC ID

Tax ID family

Physicians Toxicology Laboratory LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Physicians Toxicology Laboratory, LLC

  • Clinical Medical Laboratory
  • Tampa, FL
  • NPI 1639508757
  NPD tax ID

Locations

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

{
    "created_epoch": "1292803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292803200000",
    "number": "1508169145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 LAUREL OAK DR",
            "address_2": "STE. 102",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341082748",
            "telephone_number": "239-213-1600",
            "fax_number": "239-213-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4433 MANCHESTER RD.",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49001",
            "telephone_number": "239-213-1600",
            "fax_number": "239-213-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS TOXICOLOGY LABORATORY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-20",
        "last_updated": "2010-12-20",
        "status": "A",
        "authorized_official_last_name": "LUND",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-269-0035"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affirmatox, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Samantha Margaret Beryl Phillips, MD
• Taylor Phillips
• Yanny Phillips, DO, PHD
• Physical Therapy Associates of Kalamazoo, PC
• Physical Therapy Services of West Michigan LLC
• Physiotherapy Associates Inc
• Physiotherapy Associates Inc
• Physiotherapy Associates Inc
• Physiotherapy Associates Inc
• Physiotherapy Associates Inc

• Clinical Medical Laboratory in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Clinical Medical Laboratory in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.