Ohio River Laboratories, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

36D2050451 Issued in OH

Legal business name

OHIO RIVER LABORATORIES, LLC

Practice address

Ohio River Laboratories, LLC
1841 Mason Montgomery Rd, Unit 1C
Cincinnati, OH 45249

Phone

(832) 541-7363

Fax

(888) 409-5754

NPI assigned

Dec 13, 2012

Last updated

Mar 27, 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

Mitali Shah

Title

Owner

Phone

(832) 541-7363

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1355356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585267200000",
    "number": "1992041214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "OHIO RIVER LABORATORIES, LLC",
            "address_2": "6776 SOUTHWEST FREEWAY STE 610",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77074",
            "telephone_number": "281-617-7586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "OHIO RIVER LABORATORIES, LLC",
            "address_2": "1841 MASON MONTGOMERY RD, UNIT 1C",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45249",
            "telephone_number": "832-541-7363",
            "fax_number": "888-409-5754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO RIVER LABORATORIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-13",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "MITALI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-541-7363"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OH",
            "license": "36D2050451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "36D2050451",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Cincinnati, OH
• Providers in Cincinnati, 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 Mar 27, 2020; 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.