Medical Laboratory Diagnostics, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

0000878 Issued in NJ

Legal business name

MEDICAL LABORATORY DIAGNOSTICS, INC.

Practice address

85 Horsehill Rd
Attn Billing Dept
Cedar Knolls, NJ 07927-2003

Phone

(973) 731-2900

Fax

(973) 292-9461

NPI assigned

Jun 13, 2005

Last updated

May 17, 2016By 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

Dr. George N Mititlenes, PHD., HCLD

Title

Director

Phone

(973) 731-2900

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463443200000",
    "number": "1669476032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 HORSEHILL RD",
            "address_2": "ATTN BILLING DEPT",
            "city": "CEDAR KNOLLS",
            "state": "NJ",
            "postal_code": "079272003",
            "telephone_number": "973-731-2900",
            "fax_number": "973-292-9461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HORSEHILL RD",
            "address_2": "ATTN BILLING DEPT",
            "city": "CEDAR KNOLLS",
            "state": "NJ",
            "postal_code": "079272003",
            "telephone_number": "973-731-2900",
            "fax_number": "973-292-9461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL LABORATORY DIAGNOSTICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2016-05-17",
        "status": "A",
        "authorized_official_last_name": "MITITLENES",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "973-731-2900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD., HCLD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NJ",
            "license": "0000878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN #",
            "identifier": "304514",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD PROVIDER #",
            "identifier": "LAB 521",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET PROVIDER #",
            "identifier": "NJ0947",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2568802",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RAILROAD M/E",
            "identifier": "690927005",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Samantha Lynn Meilands, PA-C
• Samantha Marie Menza, DPT
• Metabolic Care Associates P.a.
• Suzanne Meth

• Clinical Medical Laboratory in Cedar Knolls, NJ
• Providers in Cedar Knolls, NJ by specialty
• Clinical Medical Laboratory in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2016; 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.