Consolidated Laboratory Services Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

1944LIC-3 Issued in NV

Legal business name

CONSOLIDATED LABORATORY SERVICES INC

Practice address

4275 Burnham Ave
Suite 325
Las Vegas, NV 89119-5488

Phone

(702) 933-4522

Fax

(702) 932-5271

NPI assigned

Nov 10, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Alexander Stojanoff, PHD

Title

Lab Director

Phone

(702) 933-4522

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952382400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4275 BURNHAM AVE",
            "address_2": "SUITE 325",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195488",
            "telephone_number": "702-933-4522",
            "fax_number": "702-932-5271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4275 BURNHAM AVE",
            "address_2": "SUITE 325",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195488",
            "telephone_number": "702-933-4522",
            "fax_number": "702-932-5271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSOLIDATED LABORATORY SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STOJANOFF",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "LAB DIRECTOR",
        "authorized_official_telephone_number": "702-933-4522",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NV",
            "license": "1944LIC-3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Clinical Medical Laboratory in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.