Medi-Lab Diagnostics Center LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MEDI-LAB DIAGNOSTICS CENTER LLC

Practice address

1617 25TH Ave
Gulfport, MS 39501-2834

Phone

(804) 896-6177

NPI assigned

Aug 24, 2022

Organization subpart

No

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

Authorized official

Name

Lakia Janel GainesNPI 1851046999

Title

Laboratory Director

Phone

(804) 896-6177

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lakia Janel Gaines

  • Clinical Laboratory Director (Non-physician)
  • Gulfport, MS
  • NPI 1851046999
  NPD Authorized official

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694995200000",
    "number": "1780303594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1617 25TH AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012834",
            "telephone_number": "804-896-6177",
            "fax_number": "804-451-4739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 25TH AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012834",
            "telephone_number": "804-896-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDI-LAB DIAGNOSTICS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-24",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A",
        "authorized_official_last_name": "GAINES",
        "authorized_official_first_name": "LAKIA",
        "authorized_official_middle_name": "JANEL",
        "authorized_official_title_or_position": "LABORATORY DIRECTOR",
        "authorized_official_telephone_number": "804-896-6177"
    },
    "taxonomies": [
        {
            "code": "207SM0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Medical Genetics, Molecular Genetic Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua McNiel
• Elizabeth Dowdy McQueen, LPC
• Med Link America, Inc.
• Med Management Plus
• Med-Trans Corporation
• Medi-Lift of Ms, LLC
• Medical Foundation of South Mississippi
• Medical Foundation of South Ms
• Medical Foundation of South Ms
• Medical Foundation of South Ms

• Clinical Medical Laboratory in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Clinical Medical Laboratory in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.