The Jackson Laboratory

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CL-0695 Issued in CT

Legal business name

THE JACKSON LABORATORY

Practice address

10 Discovery Dr
Farmington, CT 06032-2374

Phone

(860) 837-2300

NPI assigned

Nov 2, 2013

Last updated

Jan 30, 2023By 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

Richard Lussier

Title

Program Director, Clinic Genomics

Phone

(860) 837-2131

Specialties & licenses 1

Addresses

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": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1609205483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 MAIN ST",
            "city": "BAR HARBOR",
            "state": "ME",
            "postal_code": "046091526",
            "telephone_number": "207-288-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 DISCOVERY DR",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322374",
            "telephone_number": "860-837-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE JACKSON LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-02",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "LUSSIER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR, CLINIC GENOMICS",
        "authorized_official_telephone_number": "860-837-2131"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CT",
            "license": "CL-0695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Farmington, CT
• Providers in Farmington, CT by specialty
• Clinical Medical Laboratory in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.