Organization Active NPI

Avanti Laboratories, LLC

  • Clinical Medical Laboratory
  • San Antonio, TX
National Provider Identifier
1982165908
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
AVANTI LABORATORIES, LLC
Practice address
104 Gallery Cir
San Antonio, TX 78258-3329
Phone
(843) 655-3280
NPI assigned
Mar 31, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Authorized official

Name
Tony Osko
Title
President
Phone
(843) 655-3280

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

104 Gallery Cir
San Antonio, TX 78258-3329

Mailing address

PO Box 94285
Seattle, WA 98124-6585
Phone (843) 429-1530

Other identifiers 1

IdentifierTypeStateIssuer
411383901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200331003110 TX Part B Supplier - Independent Clinical Laboratory 3173952850 Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Locations

104 Gallery Cir
Ste 106
San Antonio, TX 78258
Phone (843) 655-3280

104 Gallery Cir
San Antonio, TX 78258
Phone (843) 655-3280

NPI Registry JSON

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

{
    "created_epoch": "1553990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758067200000",
    "number": "1982165908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94285",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981246585",
            "telephone_number": "843-429-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 GALLERY CIR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583329",
            "telephone_number": "843-655-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANTI LABORATORIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-31",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A",
        "authorized_official_last_name": "OSKO",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-655-3280"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "411383901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.