NPIMap

Organization Active NPI

Neogenomics Laboratories Inc

  • Clinical Medical Laboratory
  • Fresno, CA
National Provider Identifier
1912307547
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
00346503 Issued in CA
Legal business name
NEOGENOMICS LABORATORIES INC
Practice address
5 River Park Place East
Ste 102
Fresno, CA 93720
Phone
(866) 776-5907
Fax
(888) 443-4153
NPI assigned
Sep 2, 2014
Last updated
Mar 3, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
NEOGENOMICS LABORATORIES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Authorized official

Name
Abhishek Jain
Title
Cfo
Phone
(866) 776-5907

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 00346503 CA Primary

Addresses

Primary practice location

5 River Park Place East
Ste 102
Fresno, CA 93720

Mailing address

12701 Commonwealth Dr
Suite 9
Fort Myers, FL 33913-8626
Phone (866) 776-5907

Other identifiers 1

IdentifierTypeStateIssuer
05D2265860OtherCACLIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071116000642 CA Part B Supplier - Independent Clinical Laboratory 7113011172 10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aliso Viejo, CA; Carlsbad, CA; Fresno, CA; San Diego, CA; Sierra Madre, CA

Other NPIs on the same Medicare enrollment 10

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

National Provider Directory

National Provider Directory
Tax ID family
Neogenomics Laboratories Inc17 organizations share this tax ID, including this one
Part of
Neogenomics Laboratories Inc

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Locations

30 E River Park Pl W
Ste 400
Fresno, CA 93720
Phone 86677659072608

5 E River Park Pl E
Ste 102
Fresno, CA 93720

NPI Registry JSON

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

{
    "created_epoch": "1409616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772496000000",
    "number": "1912307547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12701 COMMONWEALTH DR",
            "address_2": "SUITE 9",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339138626",
            "telephone_number": "866-776-5907",
            "fax_number": "239-768-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 RIVER PARK PLACE EAST",
            "address_2": "STE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93720",
            "telephone_number": "866-776-5907",
            "fax_number": "888-443-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEOGENOMICS LABORATORIES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEOGENOMICS LABORATORIES INC",
        "enumeration_date": "2014-09-02",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A",
        "authorized_official_last_name": "JAIN",
        "authorized_official_first_name": "ABHISHEK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "866-776-5907"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "00346503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D2265860",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2026; 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.