Prepaid Lab, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

35045378 Issued in OH

Legal business name

PREPAID LAB, LLC

Practice address

33479 Lake Rd
Avon Lake, OH 44012-1136

Phone

(440) 930-7500

Fax

(240) 376-6325

NPI assigned

Jul 6, 2010

Last updated

Jul 6, 2010By 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. Ronald G. Hawes, M.D.

Title

Medical Director

Phone

(440) 930-7500

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278374400000",
    "number": "1508178625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 171",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440120171",
            "telephone_number": "440-930-7500",
            "fax_number": "240-376-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33479 LAKE RD",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440121136",
            "telephone_number": "440-930-7500",
            "fax_number": "240-376-6325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREPAID LAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-06",
        "last_updated": "2010-07-06",
        "status": "A",
        "authorized_official_last_name": "HAWES",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "440-930-7500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OH",
            "license": "35045378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amie Perez
• Frank Phanord
• Sarah A Phillips
• Jacarre Pinkston
• Thomas Anthony Plas, DDS
• Heidi M Prettyman
• Elizabeth Maldonado Prokay, LPCC
• Thomas Joseph Przybysz, D.C.
• John Secrest Pyke III, DDS
• Catherine Rachek

• Clinical Medical Laboratory in Avon Lake, OH
• Providers in Avon Lake, OH by specialty
• Clinical Medical Laboratory in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; 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.