Prolab Incorporated

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PROLAB INCORPORATED

Practice address

Pro-Lab Diagnostics
1301 Blue Ridge Drive Suite 101
Georgetown, TX 78626-1034

Phone

(512) 832-9145

NPI assigned

Jul 31, 2020

Organization subpart

No

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

Authorized official

Name

Daniel Saul PortilloNPI 1154068419

Title

Coo

Phone

(210) 430-8078

Specialties & licenses 1

Addresses

Other names 1

• PRO-LAB DIAGNOSTICS Doing business as

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

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

• Daniel Saul Portillo

  • Medical Microbiology Physician
  • Round Rock, TX
  • NPI 1154068419
  NPD Authorized official

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

{
    "created_epoch": "1596153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749772800000",
    "number": "1992314306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PRO-LAB DIAGNOSTICS",
            "address_2": "1301 BLUE RIDGE DRIVE SUITE 101",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786261034",
            "telephone_number": "512-832-9145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PRO-LAB DIAGNOSTICS",
            "address_2": "1301 BLUE RIDGE DRIVE SUITE 101",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786261034",
            "telephone_number": "512-832-9145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROLAB INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-31",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A",
        "authorized_official_last_name": "PORTILLO",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "SAUL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "210-430-8078"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "support@pro-lab.us",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "21 Cypress Blvd Ste 1155",
            "city": "Round Rock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786651046",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "support@pro-lab.us",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "21 Cypress Blvd Ste 1155",
            "city": "Round Rock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786651046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "PRO-LAB DIAGNOSTICS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PRO-LAB DIAGNOSTICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebekah Pridgeon, LPC
• Primal Shift Physical Therapy LLC
• Primary Foot Care
• Prime Services and Solutions LLC
• Angela Marie Procalamos, LCSW
• Ryan Sanford Prudoff, DO
• Psych Dimensions Inc
• Rosana Cecilia Puentes Medina
• Johanna Puetz, L.A.T.
• Sharon L. Pulattie, LMFT, LCDC

• Clinical Medical Laboratory in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.