Omnicare Laboratory LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

OMNICARE LABORATORY LLC

Practice address

17218 Preston Rd Ste 1050B-CD
Dallas, TX 75252-4018

Phone

(281) 917-6270

Fax

(713) 575-9067

NPI assigned

Dec 13, 2025

Organization subpart

No

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

Authorized official

Name

Prashanth Kumar Ganta

Title

Owner

Phone

(281) 917-6270

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1765584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765756800000",
    "number": "1679437602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17218 PRESTON RD STE 1050B-CD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752524018",
            "telephone_number": "281-917-6270",
            "fax_number": "713-575-9067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17218 PRESTON RD STE 1050B-CD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752524018",
            "telephone_number": "281-917-6270",
            "fax_number": "713-575-9067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNICARE LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-13",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A",
        "authorized_official_last_name": "GANTA",
        "authorized_official_first_name": "PRASHANTH KUMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-917-6270"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Dallas, TX
• Providers in Dallas, 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 Dec 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.