NPIMap

Organization Active NPI

Prohealth Laboratory

  • Clinical Medical Laboratory
  • Wallingford, CT
National Provider Identifier
1760650923
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
PROHEALTH LABORATORY
Practice address
950 Yale Ave
Wallingford, CT 06492-1858
Phone
(203) 269-3170
NPI assigned
Feb 11, 2008
Last updated
Feb 11, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
PROHEALTH PHYSICIANSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Authorized official

Name
Mr. Tim Barnard
Title
VP of Ancillary Services
Phone
(860) 284-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

950 Yale Ave
Wallingford, CT 06492-1858

Mailing address

4 Farm Springs Rd
Farmington, CT 06032-2573
Phone (860) 284-5200

National Provider Directory

National Provider Directory
Tax ID family
Prohealth Sleep Center6 organizations share this tax ID, including this one
Part of
Prohealth Sleep Center

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1760650923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 FARM SPRINGS RD",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322573",
            "telephone_number": "860-284-5200",
            "fax_number": "860-284-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 YALE AVE",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064921858",
            "telephone_number": "203-269-3170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH LABORATORY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROHEALTH PHYSICIANS",
        "enumeration_date": "2008-02-11",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "BARNARD",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "VP OF ANCILLARY SERVICES",
        "authorized_official_telephone_number": "860-284-5200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.