NPIMap

Organization Active NPI

Regional Lab Outreach

  • Clinical Medical Laboratory
  • Athens, GA
National Provider Identifier
1770987364
Registry record updated Nov 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
REGIONAL LAB OUTREACH
Practice address
1199 Prince Ave
Regional Lab Outreach
Athens, GA 30606-2797
Phone
(706) 475-3318
Fax
(706) 475-5349
NPI assigned
Oct 10, 2014
Last updated
Nov 15, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
PIEDMONT ATHENS REGIONAL MEDICAL CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 15, 2016

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

Authorized official

Name
Wendy Cook
Title
Senior Vice President and Cfo
Phone
(706) 475-3463

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 029-007 GA
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

1199 Prince Ave
Regional Lab Outreach
Athens, GA 30606-2797

Mailing address

1199 Prince Avenue
Regional Lab Outreach
Athens, GA 30606
Phone (706) 475-3318

Other identifiers 1

IdentifierTypeStateIssuer
00000074AMedicaidGA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0262005Piedmont Athens Regional Medical1199 Prince Ave, Athens, GA 30606AccreditationFeb 27, 2027
11D0689822Piedmont Athens Regional Medical Center1199 Prince Avenue, Athens, GA 30606AccreditationMar 14, 2027
11D0977116Piedmont Athens Regional Medical Center1199 Prince Ave, Athens, GA 30606AccreditationJan 23, 2027

National Provider Directory

National Provider Directory
Tax ID family
Athens Regional7 organizations share this tax ID, including this one
Part of
Athens Regional

Other organizations with this tax ID 6

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

Locations

1086 Baxter St
Athens, GA 30606
Phone (706) 353-0606

Practitioners & affiliated clinicians

Practitioners 6

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": "1412899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479168000000",
    "number": "1770987364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1199 PRINCE AVENUE",
            "address_2": "REGIONAL LAB OUTREACH",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "30606",
            "telephone_number": "706-475-3318",
            "fax_number": "706-475-5349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 PRINCE AVE",
            "address_2": "REGIONAL LAB OUTREACH",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062797",
            "telephone_number": "706-475-3318",
            "fax_number": "706-475-5349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL LAB OUTREACH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PIEDMONT ATHENS REGIONAL MEDICAL CENTER, INC.",
        "enumeration_date": "2014-10-10",
        "last_updated": "2016-11-15",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT AND CFO",
        "authorized_official_telephone_number": "706-475-3463"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "GA",
            "license": "029-007",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000074A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.