Organization Active NPI

Calloway Laboratories Inc.

Clinical Medical Laboratory
Woburn, MA

National Provider Identifier

1902826381

Registry record updated Jun 10, 2014

On this page

Key facts
NPPES NPI Registry
National Provider Directory
NPI Registry JSON
Other providers in Woburn, MA
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Clinical Medical LaboratoryTaxonomy code 291U00000X
License: 3294 Issued in MA
Legal business name: CALLOWAY LABORATORIES INC.
Practice address: 12 Gill St
Suite 4000
Woburn, MA 01801-1765
Phone: (781) 224-9899
Fax: (781) 224-2423
NPI assigned: Jul 20, 2006
Organization subpart: No

NPPES NPI Registry

Updated by the provider on Jun 10, 2014

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

Authorized official

Name: Mrs. Gail Marcus
Title: Ceo
Phone: (781) 224-9899

Specialties & licenses 2

Specialty (taxonomy)	Code	License	State	Primary
Clinical Medical Laboratory	291U00000X	22D107579	MA
Clinical Medical Laboratory	291U00000X	3294	MA	Primary

Addresses

Primary practice location

12 Gill St
Suite 4000
Woburn, MA 01801-1765

Mailing address

12 Gill St
Suite 4000
Woburn, MA 01801-1765
Phone (781) 224-9899

Other identifiers 16

Identifier	Type	State
408740200	Medicaid	MD
609588	Medicaid	NH
612379401A	Medicaid	GA
13255371	Medicaid	CO
690000029	Medicaid	AL
1012731860001	Medicaid	PA
2555391	Medicaid	OH
003123106	Medicaid	CT
100505833	Medicaid	FL
1012456	Medicaid	VT
941593	Medicaid	AZ
0800139	Medicaid	MA
2555391	Medicaid	NV
L00205	Medicaid	SC
0097098	Medicaid	NJ
416390000	Medicaid	ME

National Provider Directory

Locations

12 Gill St
Ste 4000
Woburn, MA 01801
Phone (781) 224-9899

34 Commerce Way
Woburn, MA 01801
Phone (781) 224-9899

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402358400000",
    "number": "1902826381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 GILL ST",
            "address_2": "SUITE 4000",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011765",
            "telephone_number": "781-224-9899",
            "fax_number": "781-224-2423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 GILL ST",
            "address_2": "SUITE 4000",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011765",
            "telephone_number": "781-224-9899",
            "fax_number": "781-224-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALLOWAY LABORATORIES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2014-06-10",
        "status": "A",
        "authorized_official_last_name": "MARCUS",
        "authorized_official_first_name": "GAIL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "781-224-9899",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MA",
            "license": "22D107579",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MA",
            "license": "3294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408740200",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "609588",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "612379401A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13255371",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "690000029",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012731860001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2555391",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003123106",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100505833",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012456",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "941593",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0800139",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2555391",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L00205",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0097098",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "416390000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; 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.