MDS Lab LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MDS LAB LLC

Practice address

823 S Layton Blvd
Milwaukee, WI 53215-1225

Phone

(414) 336-8918

NPI assigned

Jan 27, 2022

Organization subpart

No

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

Authorized official

Name

Vibha Surani

Title

President

Phone

(414) 336-8918

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MD'S LAB Doing business as

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mathew Andrew Tilson, APNP

  • Nurse Practitioner
  • Milwaukee, WI
  • NPI 1467763813
  NPD

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

{
    "created_epoch": "1643241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643241600000",
    "number": "1942953336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2741 W LAYTON AVE STE 201",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532212600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 S LAYTON BLVD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532151225",
            "telephone_number": "414-336-8918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDS LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-27",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A",
        "authorized_official_last_name": "SURANI",
        "authorized_official_first_name": "VIBHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-336-8918"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA LIC",
            "identifier": "52D2250416",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NONE",
            "affiliation": "N",
            "address_1": "823 S Layton Blvd",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532151225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MD'S LAB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Iantha Shanaa McWay, RDH
• Mattison Marie McWherter
• Emma McWhorter, PHD
• Tynisha L McWright, NP
• MDC Milwaukee, LLC
• Me Time Their Time Case Management Agency
• Gretchen Giselle Mead, APSW
• Diane Norma Meade
• Mackenzie Meade, PHARMD
• Sarah Nechamah Meadows

• Clinical Medical Laboratory in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Clinical Medical Laboratory in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.