NPIMap

Organization Active NPI

Crestar Labs Inc.

  • Clinical Medical Laboratory
  • Princess Anne, MD
National Provider Identifier
1861843237
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
CRESTAR LABS INC.
Practice address
12091 Somerset Ave
Princess Anne, MD 21853-1314
Phone
(410) 651-3980
Fax
(410) 651-3985
NPI assigned
Jun 28, 2016
Last updated
Oct 23, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Authorized official

Name
Fadel Yaser Alshalabi
Title
Ceo/Owner
Phone
(704) 433-8888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

12091 Somerset Ave
Princess Anne, MD 21853-1314

Mailing address

12085 Somerset Ave
Princess Anne, MD 21853-1314
Phone (410) 651-3980

National Provider Directory

National Provider Directory

Member of 1

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

NPI Registry JSON

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603411200000",
    "number": "1861843237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12085 SOMERSET AVE",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "218531314",
            "telephone_number": "410-651-3980",
            "fax_number": "410-651-3985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12091 SOMERSET AVE",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "218531314",
            "telephone_number": "410-651-3980",
            "fax_number": "410-651-3985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTAR LABS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-28",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A",
        "authorized_official_last_name": "ALSHALABI",
        "authorized_official_first_name": "FADEL",
        "authorized_official_middle_name": "YASER",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "704-433-8888"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princess Anne, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.