SLM Labs 2

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SLM LABS 2

Practice address

547 Sunrise Rd
Petal, MS 39465-9654

Phone

(228) 493-9784

NPI assigned

Feb 10, 2022

Last updated

Feb 10, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

SLM LABSAs reported in NPPES

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

Authorized official

Name

Shanna Clinton McCrory, OWNER

Title

Owner

Phone

(228) 493-9784

Specialties & licenses 1

Addresses

Other names 1

• SLM LABS Other name

Part of

SLM Labs 2

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1689328387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 SUNRISE RD",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "394659654",
            "telephone_number": "228-493-9784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "547 SUNRISE RD",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "394659654",
            "telephone_number": "228-493-9784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLM LABS 2",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SLM LABS",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "CLINTON MCCRORY",
        "authorized_official_first_name": "SHANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "228-493-9784",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SLM LABS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sandra G Russell, FNP
• Aaron Rylander, DPT
• Lacey Easterling Saul, R.D
• Coleman Sisson, PHARM. D.
• James Dale Skaggs
• Jenna Smith
• Lisa Gayle Smith, M.S., CCC-SLP
• Shonesty L. Smith, MSW
• David Lee Snodgrass, NP
• Joy Ann-Marie Sorrells, LMT

• Clinical Medical Laboratory in Petal, MS
• Providers in Petal, MS by specialty
• Clinical Medical Laboratory in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.