NPIMap

Organization Active NPI

University Hospitals Laboratory Services Foundation

Doing business as CIDEM Uiversity Hospitals Laboratory

  • Clinical Medical Laboratory
  • Cleveland, OH
National Provider Identifier
1578706438
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
36D0667996 Issued in OH
Legal business name
UNIVERSITY HOSPITALS LABORATORY SERVICES FOUNDATION
Doing business as
CIDEM Uiversity Hospitals Laboratory
Practice address
11100 Euclid Ave
Path 5077
Cleveland, OH 44106-1716
Phone
(216) 844-5678
NPI assigned
Apr 8, 2009
Organization subpart
Yes
Parent organization
UNIVERSITY HOSPITALS LABORATORY SERVICES FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Authorized official

Name
Anthony Schillero
Title
Director, FP&a
Phone
(216) 767-8141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 36D0667996 OH Primary

Addresses

Primary practice location

11100 Euclid Ave
Path 5077
Cleveland, OH 44106-1716

Mailing address

PO Box 772930
Detroit, MI 48277-2930
Phone (216) 844-5678

Other identifiers 2

IdentifierTypeStateIssuer
0915926MedicaidOH
0195926MedicaidOH

Other names 1

  • CIDEM Uiversity Hospitals Laboratory Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/Documentsubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

National Provider Directory

National Provider Directory
Tax ID family
Univ Hosp Laboratory SE5 organizations share this tax ID, including this one
Part of
Univ Hosp Laboratory SE

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1239148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1578706438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772930",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482772930",
            "telephone_number": "216-844-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "address_2": "PATH 5077",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061716",
            "telephone_number": "216-844-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY HOSPITALS LABORATORY SERVICES FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY HOSPITALS LABORATORY SERVICES FOUNDATION",
        "enumeration_date": "2009-04-08",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "SCHILLERO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "DIRECTOR, FP&A",
        "authorized_official_telephone_number": "216-767-8141"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OH",
            "license": "36D0667996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0915926",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0195926",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/Documentsubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "CIDEM Uiversity Hospitals Laboratory",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CIDEM Uiversity Hospitals Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.