Platinum Pathology, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

S4879708 Issued in VA

Legal business name

PLATINUM PATHOLOGY, LLC

Practice address

10128 W Broad St Ste H
Glen Allen, VA 23060-6761

Phone

(862) 803-1079

NPI assigned

Jul 10, 2014

Last updated

Jul 27, 2026By 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

Mr. Sathish Kothandaram

Title

President & Ceo

Phone

(855) 420-8243

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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": "1404950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785110400000",
    "number": "1699181669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 VIRGINIA MANOR RD STE 170",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207054230",
            "telephone_number": "862-298-5960",
            "fax_number": "301-259-5781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10128 W BROAD ST STE H",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230606761",
            "telephone_number": "862-803-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATINUM PATHOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-10",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A",
        "authorized_official_last_name": "KOTHANDARAM",
        "authorized_official_first_name": "SATHISH",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "855-420-8243",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "VA",
            "license": "S4879708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Clinical Medical Laboratory in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; 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.