Promedica Pathology Laboratories LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PROMEDICA PATHOLOGY LABORATORIES LLC

Practice address

2130 W Central Ave Ste 300
Toledo, OH 43606-3819

Phone

(419) 291-4134

Fax

(419) 534-2562

NPI assigned

Aug 14, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Charles A Musial

Title

President

Phone

(512) 439-1600

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534204800000",
    "number": "1952880577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12357 RIATA TRACE PKWY STE A210",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787277168",
            "telephone_number": "512-439-1600",
            "fax_number": "512-795-5069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 W CENTRAL AVE STE 300",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063819",
            "telephone_number": "419-291-4134",
            "fax_number": "419-534-2562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMEDICA PATHOLOGY LABORATORIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-14",
        "last_updated": "2018-08-14",
        "status": "A",
        "authorized_official_last_name": "MUSIAL",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-439-1600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providence Safeway Transportation, LLC

• Clinical Medical Laboratory in Toledo, OH
• Providers in Toledo, OH by specialty
• Clinical Medical Laboratory in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.