NPIMap

Organization Active NPI

Keystone Medical Laboratories, L.P.

  • Clinical Medical Laboratory
  • Dunmore, PA
National Provider Identifier
1619128592
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
39D0972528 Issued in PA
Legal business name
KEYSTONE MEDICAL LABORATORIES, L.P.
Practice address
781 Keystone Industrial Park
Dunmore, PA 18512-1530
Phone
(570) 558-4560
Fax
(570) 558-4564
NPI assigned
Oct 9, 2008
Last updated
Feb 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Authorized official

Name
Dr. Alan Shienbaum, DONPI 1811967904
Title
President
Phone
(570) 558-4560

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 39D0972528 PA Primary

Addresses

Primary practice location

781 Keystone Industrial Park
Dunmore, PA 18512-1530

Mailing address

PO Box 1878
Kingston, PA 18704-0878
Phone (570) 558-4560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081216000397 PA Part B Supplier - Independent Clinical Laboratory 8325100944 Practice locations: Dunmore, PA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0972528Keystone Medical Laboratories781 Keystone Industrial Park, Dunmore, PA 18512AccreditationJan 10, 2027

National Provider Directory

National Provider Directory

Locations

781 Keystone Industrial Park Rd
Dunmore, PA 18512
Phone (570) 340-0210

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1223510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613433600000",
    "number": "1619128592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1878",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187040878",
            "telephone_number": "570-558-4560",
            "fax_number": "570-558-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 KEYSTONE INDUSTRIAL PARK",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185121530",
            "telephone_number": "570-558-4560",
            "fax_number": "570-558-4564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE MEDICAL LABORATORIES, L.P.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-09",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A",
        "authorized_official_last_name": "SHIENBAUM",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-558-4560",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PA",
            "license": "39D0972528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunmore, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; 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.