Select Reference Laboratories, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SELECT REFERENCE LABORATORIES, LLC

Practice address

1100 Revolution Mill Dr
Suite 1
Greensboro, NC 27405-5067

Phone

(336) 510-1120

NPI assigned

Oct 20, 2016

Last updated

Oct 20, 2016By 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

James Andrew Moore

Title

Senior Accountant

Phone

(336) 235-0750

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Select Laboratories SC LLC

  • Clinical Medical Laboratory
  • Manning, SC
  • NPI 1528122678

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476921600000",
    "number": "1710438171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 REVOLUTION MILL DR",
            "address_2": "SUITE 1",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274055067",
            "telephone_number": "336-510-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 REVOLUTION MILL DR",
            "address_2": "SUITE 1",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274055067",
            "telephone_number": "336-510-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELECT REFERENCE LABORATORIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-20",
        "last_updated": "2016-10-20",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "SENIOR ACCOUNTANT",
        "authorized_official_telephone_number": "336-235-0750"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "34D2091857",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Segal, PA-C
• Dustin Shelton Segers, ATC-L
• Blanca Segovia, M.ED., CCC-SLP
• Amber Seiler
• Gifty Selby
• Select Specialty Hospital - Greensboro Inc
• Select Specialty Hospital - Greensboro Inc.
• Selectwell
• Whitney Ann Self, MS, RD, LDN
• Selfless Foundation, Inc.

• Clinical Medical Laboratory in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Clinical Medical Laboratory in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; 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.