NPIMap

Organization Active NPI

Chesapeake Diagnostic Laboratory, Inc.

  • Clinical Medical Laboratory
  • Cockeysville Hunt Valley, MD
National Provider Identifier
1528064045
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
027547D Issued in MD
Legal business name
CHESAPEAKE DIAGNOSTIC LABORATORY, INC.
Practice address
110 Old Padonia Rd
Ste 301
Cockeysville Hunt Valley, MD 21030-4948
Phone
(410) 560-5800
NPI assigned
Jun 21, 2005
Last updated
Dec 28, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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

Authorized official

Name
Shahla Moshiri, M.D.NPI 1275993503
Title
Medical Director
Phone
(410) 560-5800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 027547D MD Primary

Addresses

Primary practice location

110 Old Padonia Rd
Ste 301
Cockeysville Hunt Valley, MD 21030-4948

Mailing address

110 Old Padonia Rd
Ste 301
Cockeysville Hunt Valley, MD 21030-4948
Phone (410) 560-5800

National Provider Directory

National Provider Directory

Locations

110 Old Padonia Rd
Ste 301
Hunt Valley, MD 21030
Phone (410) 560-5800

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293494400000",
    "number": "1528064045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 OLD PADONIA RD",
            "address_2": "STE 301",
            "city": "COCKEYSVILLE HUNT VALLEY",
            "state": "MD",
            "postal_code": "210304948",
            "telephone_number": "410-560-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 OLD PADONIA RD",
            "address_2": "STE 301",
            "city": "COCKEYSVILLE HUNT VALLEY",
            "state": "MD",
            "postal_code": "210304948",
            "telephone_number": "410-560-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESAPEAKE DIAGNOSTIC LABORATORY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-21",
        "last_updated": "2010-12-28",
        "status": "A",
        "authorized_official_last_name": "MOSHIRI",
        "authorized_official_first_name": "SHAHLA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "410-560-5800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MD",
            "license": "027547D",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cockeysville Hunt Valley, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.