NPIMap

Organization Active NPI

Neogenomics Laboratories Inc

  • Clinical Medical Laboratory
  • Irvine, CA
National Provider Identifier
1699176768
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
CLF00346265 Issued in CA
Legal business name
NEOGENOMICS LABORATORIES INC
Practice address
1 Jenner
Suite 180
Irvine, CA 92618
Phone
(866) 776-5907
Fax
(949) 206-1865
NPI assigned
Sep 9, 2014
Organization subpart
Yes
Parent organization
NEOGENOMICS LABORATORIES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

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

Authorized official

Name
Sharon A Virag
Title
Cfo
Phone
(866) 776-5907

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X CLF00346265 CA Primary

Addresses

Primary practice location

1 Jenner
Suite 180
Irvine, CA 92618

Mailing address

12701 Commonwealth Dr
Suite 9
Fort Myers, FL 33913-8626
Phone (866) 776-5907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071116000642 CA Part B Supplier - Independent Clinical Laboratory 7113011172 10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aliso Viejo, CA; Carlsbad, CA; Fresno, CA; San Diego, CA; Sierra Madre, CA

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Neogenomics Laboratories

NPI Registry JSON

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

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528675200000",
    "number": "1699176768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12701 COMMONWEALTH DR",
            "address_2": "SUITE 9",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339138626",
            "telephone_number": "866-776-5907",
            "fax_number": "239-768-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JENNER",
            "address_2": "SUITE 180",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "92618",
            "telephone_number": "866-776-5907",
            "fax_number": "949-206-1865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEOGENOMICS LABORATORIES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEOGENOMICS LABORATORIES INC",
        "enumeration_date": "2014-09-09",
        "last_updated": "2018-06-11",
        "status": "A",
        "authorized_official_last_name": "VIRAG",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "866-776-5907"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLF00346265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.