Coastal Health Diagnostics Laboratory LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

COASTAL HEALTH DIAGNOSTICS LABORATORY LLC

Practice address

2227 Medusa Dr
Portland, TX 78374-3241

Phone

(361) 229-4456

NPI assigned

Mar 5, 2026

Last updated

Mar 5, 2026By 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

Anisley Perez

Title

Owner/Manager

Phone

(361) 229-4456

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1772668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772668800000",
    "number": "1659227387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2227 MEDUSA DR",
            "city": "PORTLAND",
            "state": "TX",
            "postal_code": "783743241",
            "telephone_number": "361-229-4456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2227 MEDUSA DR",
            "city": "PORTLAND",
            "state": "TX",
            "postal_code": "783743241",
            "telephone_number": "361-229-4456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL HEALTH DIAGNOSTICS LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-05",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "ANISLEY",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "361-229-4456"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Coastal Plains Community MHMR Center

• Clinical Medical Laboratory in Portland, TX
• Providers in Portland, TX by specialty
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; 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.