Specialty Laboratories, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SPECIALTY LABORATORIES, INC.

Practice address

1325 E Durango Blvd
San Antonio, TX 78210-1724

Phone

(210) 581-0574

Fax

(210) 581-1456

NPI assigned

Aug 24, 2005

Organization subpart

Yes

Parent organization

AMERIPATH INC.As reported in NPPES

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

Authorized official

Name

Michael Greene

Title

VP, Managed Care

Phone

(214) 932-8270

Specialties & licenses 2

Addresses

Other identifiers 15

Other names 1

• Mission Pharmacal Former legal business name

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Quest Diagnostics Incorporated

  • Clinical Medical Laboratory
  • Albany, NY
  • NPI 1265202147

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207008000000",
    "number": "1659364784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7111 FAIRWAY DR",
            "address_2": "SUITE 400",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334184204",
            "telephone_number": "561-712-6265",
            "fax_number": "561-712-7349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 E DURANGO BLVD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782101724",
            "telephone_number": "210-581-0574",
            "fax_number": "210-581-1456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY LABORATORIES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMERIPATH INC.",
        "enumeration_date": "2005-08-24",
        "last_updated": "2008-04-01",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VP, MANAGED CARE",
        "authorized_official_telephone_number": "214-932-8270"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0028276B",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7001173",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LOCL81784",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "98800089",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01648843",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0805777",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000420325",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10031209A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "424507",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "741041775001",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L00085",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2046360",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0511352",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1540056",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00738845A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XLAB01421",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mission Pharmacal",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Clinical Medical Laboratory in San Antonio, TX
• Providers in San Antonio, 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 Apr 1, 2008; 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.