Pretorian Labs, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PRETORIAN LABS, LLC

Practice address

7650 Hub Pkwy
Cleveland, OH 44125-5707

Phone

(440) 659-1980

Fax

(440) 659-6059

NPI assigned

May 2, 2023

Organization subpart

No

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

Authorized official

Name

Carmen Melillo

Title

Ceo

Phone

(440) 659-1980

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Pretorian Labs, LLC

  • Clinical Medical Laboratory
  • Rolling Meadows, IL
  • NPI 1770267668

  5092173898

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Pretorian Labs LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Pretorian Labs, LLC

  • Clinical Medical Laboratory
  • Rolling Meadows, IL
  • NPI 1770267668
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tracey R Burns, DPM

  • Primary Podiatric Medicine Podiatrist
  • Akron, OH
  • NPI 1043250608
  NPD

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686528000000",
    "number": "1609565100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7650 HUB PKWY",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441255707",
            "telephone_number": "440-659-1980",
            "fax_number": "440-659-6059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7650 HUB PKWY",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441255707",
            "telephone_number": "440-659-1980",
            "fax_number": "440-659-6059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRETORIAN LABS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A",
        "authorized_official_last_name": "MELILLO",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "440-659-1980"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick L. Prestridge, I.M.F.T.
• Erin Lynn Presutti, CDCA
• Laura Presutti
• Preterm Cleveland Inc
• Courtney Preto
• Pretty Stuffed LLC
• Kara Prevo
• Ellen M Prewitt, CRNP
• Rajalla E Prewitt, MD
• Maranda Priah

• Clinical Medical Laboratory in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Clinical Medical Laboratory in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.