NPIMap

Organization Active NPI

Collaborative Laboratory Services-Mount Sinai Campus

  • Clinical Medical Laboratory
  • Hartford, CT
National Provider Identifier
1841208345
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
CL-0625 Issued in CT
Legal business name
COLLABORATIVE LABORATORY SERVICES-MOUNT SINAI CAMPUS
Practice address
114 Woodland St
Hartford, CT 06105-1208
Phone
(860) 714-2802
NPI assigned
Aug 3, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Donald Straceski
Title
Vice President of Financial Manage
Phone
(860) 714-4609

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X CL-0625 CT Primary

Addresses

Primary practice location

114 Woodland St
Hartford, CT 06105-1208

Mailing address

500 Blue Hills Ave
Hartford, CT 06112-1500

Other identifiers 1

IdentifierTypeStateIssuer
2V4067OtherCTHEALTHNET

National Provider Directory

National Provider Directory
Tax ID family
Cobius Healthcare Solutions3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841208345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 BLUE HILLS AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061121500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 WOODLAND ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051208",
            "telephone_number": "860-714-2802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLABORATIVE LABORATORY SERVICES-MOUNT SINAI CAMPUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STRACESKI",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCIAL MANAGE",
        "authorized_official_telephone_number": "860-714-4609"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CT",
            "license": "CL-0625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2V4067",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.