NPIMap

Organization Active NPI

Physicians Laboratory, LTD.

  • Anatomic Pathology & Clinical Pathology Physician
  • Sioux Falls, SD
National Provider Identifier
1700050499
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
PHYSICIANS LABORATORY, LTD.
Practice address
1301 South Cliff Avenue
Suite 700
Sioux Falls, SD 57105-1019
Phone
(605) 322-7200
Fax
(605) 322-7222
NPI assigned
Apr 15, 2008
Last updated
Sep 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Authorized official

Name
Lee J Brandt
Title
Administrator
Phone
(605) 322-7208

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X NU Primary

Addresses

Primary practice location

1301 South Cliff Avenue
Suite 700
Sioux Falls, SD 57105-1019

Mailing address

PO Box 5050
Sioux Falls, SD 57117-5050
Phone (605) 322-7200

Other names 1

  • Physicians Laboratory Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071128000369 SD Part B Supplier - Independent Clinical Laboratory 9234036310 Practice locations: Sioux Falls, SD

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Physicians Laboratory2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1301 S Cliff Ave
Ste 700
Sioux Falls, SD 57105
Phone (605) 322-7200

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662422400000",
    "number": "1700050499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5050",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175050",
            "telephone_number": "605-322-7200",
            "fax_number": "605-322-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SOUTH CLIFF AVENUE",
            "address_2": "SUITE 700",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051019",
            "telephone_number": "605-322-7200",
            "fax_number": "605-322-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS LABORATORY, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A",
        "authorized_official_last_name": "BRANDT",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "605-322-7208"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physicians Laboratory",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Physicians Laboratory",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.