Renalab Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

25D0883339 Issued in MS

Legal business name

RENALAB INC

Practice address

197 Interstate Drive
Suite G
Richland, MS 39218

Phone

(615) 370-6760

Fax

(615) 370-6766

NPI assigned

Aug 3, 2006

Organization subpart

No

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

Authorized official

Name

Michael Thomas Burney

Title

Coo

Phone

(615) 370-6740

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1912914516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 403096",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303843096",
            "telephone_number": "615-370-6760",
            "fax_number": "615-370-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 INTERSTATE DRIVE",
            "address_2": "SUITE G",
            "city": "RICHLAND",
            "state": "MS",
            "postal_code": "39218",
            "telephone_number": "615-370-6760",
            "fax_number": "615-370-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENALAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "BURNEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "615-370-6740"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MS",
            "license": "25D0883339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00118180",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cari A Ray, SLP
• Katie Rayborn, LPN
• Recovercare, LLC
• Marisa Anne Reed, NP
• Rehab Medical LLC
• Richland Caring Hands, Inc.
• Richland Primary Care Center
• River Oaks Management Company, LLC
• River Oaks Management Company, LLC
• Louie Greg Ross, FNP-BC

• All providers in Richland, MS
• Clinical Medical Laboratory in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; 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.