Organization Active NPI

Advanced Molecular Diagnostics, LLC

  • Clinical Medical Laboratory
  • Montvale, NJ
National Provider Identifier
1790023547
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
0006626 Issued in NJ
Legal business name
ADVANCED MOLECULAR DIAGNOSTICS, LLC
Practice address
136 Summit Avenue
East Wing
Montvale, NJ 07645-1223
Phone
(201) 825-0186
Fax
(201) 825-0191
NPI assigned
Jan 29, 2013
Last updated
Dec 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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

Authorized official

Name
Pablo J Umansky, PHD
Title
Ceo
Phone
(201) 825-0186

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 0006626 NJ Primary

Addresses

Primary practice location

136 Summit Avenue
East Wing
Montvale, NJ 07645-1223

Mailing address

136 Summit Avenue
East Wing
Montvale, NJ 07645-1223
Phone (201) 825-0186

Other identifiers 2

IdentifierTypeStateIssuer
0366781MedicaidNY
366781MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130524000191 NJ Part B Supplier - Independent Clinical Laboratory 6406093699 Practice locations: Montvale, NJ

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
31D2053667Advanced Molecular Diagnostics, LLC136 Summit Ave East Wing, Montvale, NJ 07645AccreditationJul 22, 2028

National Provider Directory

National Provider Directory

Locations

136 Summit Ave
Montvale, NJ 07645
Phone (201) 825-0186

136 Summit Ave
Fl First
Montvale, NJ 07645

19 Spear Rd
Ste 312
Ramsey, NJ 07446
Phone (866) 436-3263

535 E Crescent Ave
Ste 1
Ramsey, NJ 07446

535 E Crescent Ave
Ste 100
Ramsey, NJ 07446

4060 Innslake Dr
Glen Allen, VA 23060
Phone (800) 858-5909

Practitioners & affiliated clinicians

Practitioners 1

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": "1359417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767052800000",
    "number": "1790023547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 SUMMIT AVENUE",
            "address_2": "EAST WING",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451223",
            "telephone_number": "201-825-0186",
            "fax_number": "201-825-0191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 SUMMIT AVENUE",
            "address_2": "EAST WING",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451223",
            "telephone_number": "201-825-0186",
            "fax_number": "201-825-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MOLECULAR DIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-29",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A",
        "authorized_official_last_name": "UMANSKY",
        "authorized_official_first_name": "PABLO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "201-825-0186",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NJ",
            "license": "0006626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0366781",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "366781",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montvale, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.