Atlantic Diagnostic Laboratories, LLC.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

024997 Issued in PA

Legal business name

ATLANTIC DIAGNOSTIC LABORATORIES, LLC.

Practice address

3520 Progress Dr
Suite C
Bensalem, PA 19020-5810

Phone

(267) 525-2470

Fax

(267) 525-2488

NPI assigned

Aug 19, 2008

Last updated

Nov 3, 2016By 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

Aaron Domenico

Title

Coo

Phone

(267) 525-2470

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Atlantic Diagnostic Laboratories, LLC

  • Clinical Medical Laboratory
  • Milford, CT
  • NPI 1811441751

  1153498811

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Atlantic Diagnostics Laboratories

  • Clinical Medical Laboratory
  • Upper Darby, PA
  • NPI 1164660643

  O20080922000375

  Same enrollment

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

CLIA laboratory certificates

Tax ID family

Atlantic Diagnostics Laboratories3 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.

• Atlantic Diagnostic Laboratories, LLC

  • Clinical Medical Laboratory
  • Mercer, PA
  • NPI 1225424294
  NPD tax ID
• Atlantic Diagnostic Laboratories, LLC

  • Clinical Medical Laboratory
  • Milford, CT
  • NPI 1811441751
  NPD tax ID

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

• Atlantic Diagnostic Laboratories, LLC

  • Clinical Medical Laboratory
  • Mercer, PA
  • NPI 1225424294

  Member Of

  NPD member
• Xeron Clinical Laboratories Inc.

  • Clinical Medical Laboratory
  • Kenilworth, NJ
  • NPI 1336361575

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478131200000",
    "number": "1881841120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3520 PROGRESS DR",
            "address_2": "SUITE C",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190205810",
            "telephone_number": "267-525-2470",
            "fax_number": "267-525-2488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 PROGRESS DR",
            "address_2": "SUITE C",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190205810",
            "telephone_number": "267-525-2470",
            "fax_number": "267-525-2488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC DIAGNOSTIC LABORATORIES, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-19",
        "last_updated": "2016-11-03",
        "status": "A",
        "authorized_official_last_name": "DOMENICO",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "267-525-2470"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PA",
            "license": "024997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL LABORATORY PERMIT",
            "identifier": "024997",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Bensalem, PA
• Providers in Bensalem, PA by specialty
• Clinical Medical Laboratory in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; 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.