Active NPI
Renalytix Ai, Inc.
- Clinical Medical Laboratory
- Long Island City, NY
National Provider Identifier
1700420361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- RENALYTIX AI, INC.
- Practice address
- 30-02 48TH Ave.
Suite 150
Long Island City, NY 11101-3432 - Phone
- (646) 397-3970
- NPI assigned
- Nov 6, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- James McCullough
- Title
- Ceo
- Phone
- (888) 203-2725
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
30-02 48TH Ave.
Suite 150
Long Island City, NY 11101-3432
Mailing address
PO Box 2460
Carol Stream, IL 60132-2460
Phone (480) 861-1383
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200909001750 | NY | Part B Supplier - Independent Clinical Laboratory | 6002244373 | Practice locations: Long Island City, NY |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D2156875 | Renalytix Ai, Inc | Compliance | Mar 26, 2027 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
1615 Pasadena Ave S
Ste 250
South Pasadena, FL 33707
Phone (727) 381-7727
3002 48th Ave
Ste 150
Long Island City, NY 11101
421 S Wakara Way
Ste 309
Salt Lake Cty, UT 84108
Phone (646) 397-3970
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572998400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1785456000000",
"number": "1700420361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2460",
"city": "CAROL STREAM",
"state": "IL",
"postal_code": "601322460",
"telephone_number": "480-861-1383",
"fax_number": "201-345-1291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30-02 48TH AVE.",
"address_2": "SUITE 150",
"city": "LONG ISLAND CITY",
"state": "NY",
"postal_code": "111013432",
"telephone_number": "646-397-3970"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RENALYTIX AI, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2019-11-06",
"last_updated": "2026-07-31",
"certification_date": "2026-07-31",
"status": "A",
"authorized_official_last_name": "MCCULLOUGH",
"authorized_official_first_name": "JAMES",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "888-203-2725"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Long Island City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.