Organization Active NPI

United Clinical Laboratory LLC

  • Clinical Medical Laboratory
  • West Palm Beach, FL
National Provider Identifier
1558745422
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
UNITED CLINICAL LABORATORY LLC
Practice address
2257 Vista Pkwy
Suite 2
West Palm Beach, FL 33411-2724
Phone
(844) 291-4292
Fax
(561) 616-9087
NPI assigned
Jul 10, 2015
Last updated
Sep 27, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2019

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

Authorized official

Name
Mr. Kirill Vesselov
Title
Ceo
Phone
(844) 291-4292

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X FL Primary

Addresses

Primary practice location

2257 Vista Pkwy
Suite 2
West Palm Beach, FL 33411-2724

Mailing address

2257 Vista Parkway
Suite 2
West Palm Beach, FL 33411
Phone (844) 291-4292

National Provider Directory

National Provider Directory

Locations

2257 Vista Pkwy
Ste 2
West Palm Beach, FL 33411
Phone (718) 730-3550

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": "1436486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569542400000",
    "number": "1558745422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2257 VISTA PARKWAY",
            "address_2": "SUITE 2",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33411",
            "telephone_number": "844-291-4292",
            "fax_number": "561-616-9087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2257 VISTA PKWY",
            "address_2": "SUITE 2",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334112724",
            "telephone_number": "844-291-4292",
            "fax_number": "561-616-9087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED CLINICAL LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-10",
        "last_updated": "2019-09-27",
        "status": "A",
        "authorized_official_last_name": "VESSELOV",
        "authorized_official_first_name": "KIRILL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "844-291-4292",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; 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.