Innovexlab

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

INNOVEXLAB

Practice address

1135 NW 23Rd Ave Ste L
Gainesville, FL 32609-3449

Phone

(352) 328-3066

NPI assigned

Apr 12, 2024

Organization subpart

No

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

Authorized official

Name

Pratibha Srivastava, PH. D.

Title

Member Manager

Phone

(850) 339-0927

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

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

{
    "created_epoch": "1712880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1891549242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5830 SW 85TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326088525",
            "telephone_number": "850-339-0927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 NW 23RD AVE STE L",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326093449",
            "telephone_number": "352-328-3066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVEXLAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-12",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "SRIVASTAVA",
        "authorized_official_first_name": "PRATIBHA",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "850-339-0927",
        "authorized_official_credential": "PH. D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Innocent Odocha MD PA
• Innocent Odocha, M.D.,P.a.
• Innovate Health Medical Clinic Corp
• Innovation Home Health Care LLC
• Innovative Back Solutions,LLC
• Brendan Toshiyasu Inouye, M.D.
• Gabriella Insabella, PA-C
• Insightful Counseling Services, Inc.
• Domenic Inskip
• Integrated Dermatology of Gainesville, LLC

• Clinical Medical Laboratory in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.