Active NPI
Woodbury Clinical Laboratory, Inc.
- Clinical Medical Laboratory
- Lebanon, TN
National Provider Identifier
1801851233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- 0000002135
- Legal business name
- WOODBURY CLINICAL LABORATORY, INC.
- Practice address
- 305 E High St
Lebanon, TN 37087-2901 - Phone
- (615) 443-7588
- Fax
- (615) 443-7458
- NPI assigned
- Apr 19, 2006
- Organization subpart
- Yes
- Parent organization
- AMERICAN ESOTERIC LABORATORIES
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Delia Oldham
- Title
- Director of Operations
- Phone
- (615) 443-7588
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 0000002135 | TN | Primary |
Addresses
Primary practice location
305 E High St
Lebanon, TN 37087-2901
Mailing address
PO Box 2309
Lebanon, TN 37088-2309
Phone (615) 443-7588
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000002135 | Other | TN | STATE MEDICAL LABORATORY |
| 44D0659026 | Other | TN | CLIA CERTIFICATE OF COMPL |
National Provider Directory
National Provider Directory- Part of
- Clinical Reference Lab
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145404800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1219017600000",
"number": "1801851233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2309",
"city": "LEBANON",
"state": "TN",
"postal_code": "370882309",
"telephone_number": "615-443-7588",
"fax_number": "615-443-7458"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 E HIGH ST",
"city": "LEBANON",
"state": "TN",
"postal_code": "370872901",
"telephone_number": "615-443-7588",
"fax_number": "615-443-7458"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WOODBURY CLINICAL LABORATORY, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "AMERICAN ESOTERIC LABORATORIES",
"enumeration_date": "2006-04-19",
"last_updated": "2008-08-18",
"status": "A",
"authorized_official_last_name": "OLDHAM",
"authorized_official_first_name": "DELIA",
"authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
"authorized_official_telephone_number": "615-443-7588",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "TN",
"license": "0000002135",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE MEDICAL LABORATORY",
"identifier": "0000002135",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA CERTIFICATE OF COMPL",
"identifier": "44D0659026",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.