Clinical Laboratory Manangement, Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

00007510 Issued in NJ

Legal business name

CLINICAL LABORATORY MANANGEMENT, INC

Practice address

2124 Morris Ave
Union, NJ 07083-6042

Phone

(908) 810-1113

Fax

(908) 810-1109

NPI assigned

Sep 13, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Timothy C Peckham

Title

Executive Director Business Operati

Phone

(908) 810-1113

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245628800000",
    "number": "1598860082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1806",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070831806",
            "telephone_number": "908-810-1113",
            "fax_number": "908-810-1109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 MORRIS AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070836042",
            "telephone_number": "908-810-1113",
            "fax_number": "908-810-1109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL LABORATORY MANANGEMENT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2009-06-22",
        "status": "A",
        "authorized_official_last_name": "PECKHAM",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR BUSINESS OPERATI",
        "authorized_official_telephone_number": "908-810-1113",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PA",
            "license": "028999",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NY",
            "license": "PFI7930",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "DE",
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NJ",
            "license": "00007510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; 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.