NPIMap

Organization Active NPI

Boston Clinical Laboratories, Inc

  • Clinical Medical Laboratory
  • Waltham, MA
National Provider Identifier
1730158783
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
3174 Issued in MA
Legal business name
BOSTON CLINICAL LABORATORIES, INC
Practice address
764A Main St
Waltham, MA 02451-0603
Phone
(781) 893-1995
NPI assigned
Mar 14, 2006
Last updated
Mar 27, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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

Authorized official

Name
Zahra Sheikhinejad, PHD
Title
President
Phone
(781) 893-1995

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 3174 MA Primary

Addresses

Primary practice location

764A Main St
Waltham, MA 02451-0603

Mailing address

764A Main St
Waltham, MA 02451-0603

Other identifiers 1

IdentifierTypeStateIssuer
TR-0062MedicaidMA

National Provider Directory

National Provider Directory

Locations

1231 Washington St
Ste 1
Newton, MA 02465
Phone (617) 630-9200

764A Main St
Waltham, MA 02451
Phone (781) 893-1995

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364342400000",
    "number": "1730158783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "764A MAIN ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024510603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "764A MAIN ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024510603",
            "telephone_number": "781-893-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON CLINICAL LABORATORIES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2013-03-27",
        "status": "A",
        "authorized_official_last_name": "SHEIKHINEJAD",
        "authorized_official_first_name": "ZAHRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-893-1995",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MA",
            "license": "3174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TR-0062",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.