Buena Vista Labs LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

BUENA VISTA LABS LLC

Practice address

25K Olympia Ave
Woburn, MA 01801-7245

Phone

(781) 904-3130

Fax

(954) 990-6305

NPI assigned

Sep 15, 2021

Organization subpart

No

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

Authorized official

Name

Sherita N Chang

Title

Manager

Phone

(954) 993-2040

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642377600000",
    "number": "1669142279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "759 CHIEF JUSTICE CUSHING HWY STE 359",
            "city": "COHASSET",
            "state": "MA",
            "postal_code": "020252115",
            "fax_number": "954-990-6305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25K OLYMPIA AVE",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018017245",
            "telephone_number": "781-904-3130",
            "fax_number": "954-990-6305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUENA VISTA LABS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-15",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "SHERITA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "954-993-2040"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "22D2227755",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gail M Brykman, LICSW
• Justin Buchanan
• Kayla Buckley, PT
• Rebekah A. Buehler, OTR/L
• Katherine Lynn Buell
• Firdous Bukhari
• Gail Buki, CCC-SLP
• Erwin Joseph Bulan, M.D.
• Elizabeth A Burba-Dick, MD
• Katherine Anne Burchfiel, MA

• Clinical Medical Laboratory in Woburn, MA
• Providers in Woburn, MA by specialty
• Clinical Medical Laboratory in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.