Clinical Laboratory Group Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

10D200128 Issued in FL

Legal business name

CLINICAL LABORATORY GROUP INC

Practice address

298 S Lawrence Blvd
Keystone Heights, FL 32656-9217

Phone

(352) 473-8483

NPI assigned

Mar 7, 2010

Last updated

Mar 7, 2010By 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

Mr. Darren David Lotow

Title

Owner

Phone

(352) 514-7920

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1267920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267920000000",
    "number": "1659694503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19804 NE 22ND LN",
            "city": "HAWTHORNE",
            "state": "FL",
            "postal_code": "326402900",
            "telephone_number": "352-514-7920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 S LAWRENCE BLVD",
            "city": "KEYSTONE HEIGHTS",
            "state": "FL",
            "postal_code": "326569217",
            "telephone_number": "352-473-8483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL LABORATORY GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-07",
        "last_updated": "2010-03-07",
        "status": "A",
        "authorized_official_last_name": "LOTOW",
        "authorized_official_first_name": "DARREN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-514-7920",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "10D200128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Caradonna, PHARMD
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• Jessica Marie Cummings-Nigh, APRN
• Robert Edward Daley, RPH

• Clinical Medical Laboratory in Keystone Heights, FL
• Providers in Keystone Heights, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2010; 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.