Statlab Diagnostics, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

STATLAB DIAGNOSTICS, LLC

Practice address

3810 Irving St
Denver, CO 80211

Phone

(303) 756-1020

NPI assigned

Nov 10, 2020

Last updated

Feb 10, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shideh Kerman

Title

Ceo

Phone

(303) 547-2100

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Locations

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.

• Johnny Shen, M.D.

  • Family Medicine Physician
  • Denver, CO
  • NPI 1881988541
  NPD

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

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675987200000",
    "number": "1790387223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 IRVING ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80211",
            "telephone_number": "303-756-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 IRVING ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80211",
            "telephone_number": "303-756-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATLAB DIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-10",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A",
        "authorized_official_last_name": "KERMAN",
        "authorized_official_first_name": "SHIDEH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "303-547-2100"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kualani Dejale' Staten, CNA
• David P States
• Diane States, PMHNP-BC
• Kristy Joelle States, OTR
• Eleni Theodora Stathopulos
• Barbara D Statland, MD
• Elizabeth Staudacher
• William Staudenmaier, PH.D.
• Herman Staudenmayer, PHD
• Brian L Stauffer, MD

• Clinical Medical Laboratory in Denver, CO
• Providers in Denver, CO by specialty
• Clinical Medical Laboratory in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; 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.