NPIMap

Organization Active NPI

Kent Pathology Laboratory PLLC

  • Clinical Medical Laboratory
  • Grand Rapids, MI
National Provider Identifier
1982660734
Registry record updated Jun 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
CLIA 23D0714247 Issued in MI
Legal business name
KENT PATHOLOGY LABORATORY PLLC
Practice address
2650 Horizon Dr SE
Suite B
Grand Rapids, MI 49546-7519
Phone
(616) 458-1255
Fax
(616) 458-1292
NPI assigned
Apr 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2010

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

Authorized official

Name
Dr. John C Pui, M.D.
Title
Director
Phone
(616) 458-1255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X CLIA 23D0714247 MI Primary

Addresses

Primary practice location

2650 Horizon Dr SE
Suite B
Grand Rapids, MI 49546-7519

Mailing address

2650 Horizon Dr SE
Suite B
Grand Rapids, MI 49546-7519
Phone (616) 458-1255

Other names 1

  • Kent Pathology Laboratory LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

245 State St SE
Ste 201
Grand Rapids, MI 49503
Phone (616) 458-1255

2650 Horizon Dr SE
Ste B
Grand Rapids, MI 49546
Phone (616) 458-1255

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276732800000",
    "number": "1982660734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 HORIZON DR SE",
            "address_2": "SUITE B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467519",
            "telephone_number": "616-458-1255",
            "fax_number": "616-458-1292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 HORIZON DR SE",
            "address_2": "SUITE B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467519",
            "telephone_number": "616-458-1255",
            "fax_number": "616-458-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENT PATHOLOGY LABORATORY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-21",
        "last_updated": "2010-06-17",
        "status": "A",
        "authorized_official_last_name": "PUI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "616-458-1255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MI",
            "license": "CLIA  23D0714247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kent Pathology Laboratory LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2010; 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.