NPIMap

Organization Active NPI

United Clinical Laboratories, Inc

  • Clinical Medical Laboratory
  • Dubuque, IA
National Provider Identifier
1871596676
Registry record updated Jul 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
16D0648073 Issued in IA
Legal business name
UNITED CLINICAL LABORATORIES, INC
Practice address
205 Bluff St
Suite 1
Dubuque, IA 52001-6979
Phone
(563) 556-2010
Fax
(563) 556-0986
NPI assigned
May 24, 2005
Last updated
Jul 29, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2013

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

Authorized official

Name
Dr. Andrew D Vanderheyden, MD
Title
Medical Director
Phone
(563) 556-2010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 16D0648073 IA Primary

Addresses

Primary practice location

205 Bluff St
Suite 1
Dubuque, IA 52001-6979

Mailing address

205 Bluff St
Dubuque, IA 52001-6979
Phone (563) 556-2010

Other identifiers 1

IdentifierTypeStateIssuer
0002493MedicaidIA

National Provider Directory

National Provider Directory

Member of 3

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

Locations

205 Bluff St
Dubuque, IA 52001
Phone (319) 556-2012

205 Bluff St
Ste 1
Dubuque, IA 52001
Phone (319) 557-9170

250 Mercy Dr
Dubuque, IA 52001
Phone (563) 589-8000

918 W Platt St
Maquoketa, IA 52060
Phone (563) 652-5145

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375056000000",
    "number": "1871596676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 BLUFF ST",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016979",
            "telephone_number": "563-556-2010",
            "fax_number": "563-556-0986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 BLUFF ST",
            "address_2": "SUITE 1",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016979",
            "telephone_number": "563-556-2010",
            "fax_number": "563-556-0986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED CLINICAL LABORATORIES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2013-07-29",
        "status": "A",
        "authorized_official_last_name": "VANDERHEYDEN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "563-556-2010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IA",
            "license": "16D0648073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0002493",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; 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.