Las Vegas Laboratory LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

LAS VEGAS LABORATORY LLC

Practice address

4570 S Eastern Ave Ste 23
Las Vegas, NV 89119-6183

Phone

(510) 456-8143

NPI assigned

Aug 29, 2022

Organization subpart

No

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

Authorized official

Name

Louise Mourielle Hernandez

Title

Managing Member

Phone

(510) 456-8143

Specialties & licenses 1

Addresses

Other names 1

• 1st American Diagnostic Laboratory Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1760102040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4570 S EASTERN AVE STE 23",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196183",
            "telephone_number": "510-456-8143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4570 S EASTERN AVE STE 23",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196183",
            "telephone_number": "510-456-8143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAS VEGAS LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-29",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "LOUISE MOURIELLE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "510-456-8143"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "1st American Diagnostic Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Las Vegas Integrative Dermatology PLLC
• Las Vegas International Center for Advance Gynecologic Care
• Las Vegas Iovera Center
• Las Vegas Ketamine LLC
• Las Vegas Kidney Specialists Janga LLP
• Las Vegas Lungs LLC
• Las Vegas Mark LLC
• Las Vegas Medical Group LLC
• Las Vegas Medical Legal Consulting LLC
• Las Vegas Medical Legal Consulting LLC

• Clinical Medical Laboratory in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Clinical Medical Laboratory in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.