North West Labs, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

291U00000X Issued in MI

Legal business name

NORTH WEST LABS, INC.

Practice address

29580 Northwestern Hwy Ste 120
Southfield, MI 48034-1087

Phone

(248) 301-6917

Fax

(248) 301-6805

NPI assigned

Mar 28, 2017

Last updated

Oct 25, 2024By 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

Mr. Omar Elias

Title

President

Phone

(248) 301-6917

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

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": "1490659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729814400000",
    "number": "1568994879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29580 NORTHWESTERN HWY STE 120",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341087",
            "telephone_number": "248-301-6917",
            "fax_number": "248-301-6805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29580 NORTHWESTERN HWY STE 120",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341087",
            "telephone_number": "248-301-6917",
            "fax_number": "248-301-6805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH WEST LABS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-28",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A",
        "authorized_official_last_name": "ELIAS",
        "authorized_official_first_name": "OMAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-301-6917",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MI",
            "license": "291U00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Southfield, MI
• Providers in Southfield, 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 Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.