Active NPI
Advantis Laboratories LLC
- Clinical Medical Laboratory
- Kernersville, NC
National Provider Identifier
1982142345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- ADVANTIS LABORATORIES LLC
- Practice address
- 256 Gretas Way Ste 105
Kernersville, NC 27284-3889 - Phone
- (843) 429-1530
- NPI assigned
- Feb 6, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Imad Osko
- Title
- President
- Phone
- (843) 429-1530
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
256 Gretas Way Ste 105
Kernersville, NC 27284-3889
Mailing address
PO Box 3664
Seattle, WA 98124-3664
Phone (843) 429-1530
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170607000022 | SC | Part B Supplier - Independent Clinical Laboratory | 3072880442 | Practice locations: Longs, SC |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D2335811 | Advantis Laboratories LLC | Registration | Dec 17, 2027 |
National Provider Directory
National Provider DirectoryLocations
256 Gretas Way
Ste 105
Kernersville, NC 27284
Phone (843) 429-1530
1650 Highway 9 E
Unit 1
Longs, SC 29568
Phone (512) 213-8079
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486339200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1773014400000",
"number": "1982142345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3664",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981243664",
"telephone_number": "843-429-1530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "256 GRETAS WAY STE 105",
"city": "KERNERSVILLE",
"state": "NC",
"postal_code": "272843889",
"telephone_number": "843-429-1530"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADVANTIS LABORATORIES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-02-06",
"last_updated": "2026-03-09",
"certification_date": "2026-03-09",
"status": "A",
"authorized_official_last_name": "OSKO",
"authorized_official_first_name": "IMAD",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "843-429-1530"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kernersville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.