East Side Clinical Laboratory, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

LCI00449 Issued in RI

Legal business name

EAST SIDE CLINICAL LABORATORY, INC.

Practice address

10 Risho Ave
East Providence, RI 02914-1227

Phone

(401) 455-8400

Fax

(401) 455-8444

NPI assigned

Aug 13, 2006

Last updated

Sep 30, 2024By 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

Alan M. Greenberg

Title

President

Phone

(516) 396-5800

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in RI, MA, CT3 enrollments

Enrollment records 3

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

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Sunrise Medical Laboratories, Inc.

  • Clinical Medical Laboratory
  • Hicksville, NY
  • NPI 1376587113

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1861404121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 RISHO AVE",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029141227",
            "telephone_number": "401-455-8400",
            "fax_number": "401-455-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 RISHO AVE",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029141227",
            "telephone_number": "401-455-8400",
            "fax_number": "401-455-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST SIDE CLINICAL LABORATORY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-13",
        "last_updated": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "GREENBERG",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-396-5800"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "RI",
            "license": "LCI00449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9418005",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• East Providence Dental Care, LLC
• East Providence Emergency Room Inc (East Providence Urgent Care)
• East Providence Footcare,Inc.
• East Providence Senior Center
• East Providence Senior Center (DSMT Program Health Nutrition Diabetes Office EPSC)
• Eastgate Nursing and Recovery Center Inc.
• Eastside Neurology, Inc.
• Eldercare Consultants Home Care
• Elysian Psychotherapy
• Emma Pendleton Bradley Hospital

• Clinical Medical Laboratory in East Providence, RI
• Providers in East Providence, RI by specialty
• Clinical Medical Laboratory in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.