Imvaria Labs LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

IMVARIA LABS LLC

Practice address

1515 Crescent Dr Ste 100
Carrollton, TX 75006-3628

Phone

(650) 683-9800

NPI assigned

May 6, 2024

Organization subpart

No

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

Authorized official

Name

Michael Muelly, MD

Title

Ceo

Phone

(650) 683-9809

Specialties & licenses 1

Addresses

Other names 1

• IMVARIA Labs Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

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

• Joshua Jay Reicher, M.D.

  • Diagnostic Radiology Physician
  • Palo Alto, CA
  • NPI 1346508629
  NPD

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714953600000",
    "number": "1821845934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2930 DOMINGO AVE # 1025",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052454",
            "telephone_number": "650-683-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 CRESCENT DR STE 100",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750063628",
            "telephone_number": "650-683-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMVARIA LABS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-02",
        "status": "A",
        "authorized_official_last_name": "MUELLY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "650-683-9809",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMVARIA Labs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physiological Laboratory in Carrollton, TX
• Providers in Carrollton, TX by specialty
• Physiological Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.