QUALITY CLINICAL LAB LLC (NPI# 1083117535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083117535 |
| Entity Type | Organization |
| Organization Name | QUALITY CLINICAL LAB LLC |
| Other Organization Name | EXPRESS LABORATORY SERVICES, LLC |
| Practice Address |
2204 Us Highway 19 Holiday FL 34691-4351 |
| Mailing Address |
Po Box 1561 Palm Harbor FL 34682-1561 |
| Practice Telephone | 8133349234 |
| Practice Fax Number | 8133349234 |
| Mailing Telephone | 8133349234 |
| Enumeration Date | 2018-03-12 |
| Last Update Date | 2020-05-25 |
| Authorized Official Name | KERIEN MARTIJA (OWNER) |
| Authorized Official Telephone | 8133349234 |
| Is Organization Subpart | Y |
| Parent Organization Name | EXPRESS LABORATORY SERVICES , INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247ZC0005X |
Pathology Specialization: Clinical Laboratory Director, Non-physician |
Technologists, Technicians & Other Technical Service Providers |
| Other Name | Type Code |
|---|---|
| EXPRESS LABORATORY SERVICES, LLC | Doing Business As Name - Organization |
| Street Address |
2204 US HIGHWAY 19 |
| City | HOLIDAY |
| State | FL |
| Zip Code | 34691-4351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417407826 | Janet Hernandez | Nurse Practitioner | 2435 Us Hwy 19, Suite 210, Holiday, FL 34691 | 2016-10-10 |
| 1285081869 | Jeannie Giberson | General Acute Care Hospital | 4313 Tahitian Gardens Drive K2, Holiday, FL 34691 | 2016-05-24 |
| 1790108058 | Home Medical Visits LLC | Internal Medicine | 2435 Us Highway 19 Ste 300, Holiday, FL 34691 | 2014-01-22 |
| 1770878712 | Rachel Rosa | Behavioral Analyst | 4249 Plaza Drive #304, Holiday, FL 34691 | 2011-06-17 |
| 1144414574 | Shervin Ardalani | Dentist | 4539 Sunray Drive, None, Holiday, FL 34691 | 2007-08-29 |
| 1245440874 | Gulf Coast Jewish Family Services | Psychiatric Residential Treatment Facility | 3142 Darlington Road, Holiday, FL 34691 | 2007-05-23 |
| 1659416626 | Michael M Shaw | Counselor | 2425 Chatlin Road, Holiday, FL 34691 | 2007-02-20 |
| 1316957947 | George William Lazenby | Ophthalmology | 1109 Us Hwy 19, Holiday, FL 34691 | 2006-08-08 |
| 1770531899 | Rajesh V Patel | Internal Medicine | 1162 Alternate 19 N, Holiday, FL 34691 | 2006-05-04 |
| 1871560904 | Vikram M Atit | Psychiatry & Neurology | 1011 Us Hwy 19, Holiday, FL 34691 | 2006-03-07 |
| Find all providers in zip 34691 | ||||
| Taxonomy Code | 247ZC0005X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Pathology |
| Specialization | Clinical Laboratory Director, Non-physician |
| An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405. |
| Notes: Source: National Uniform Claim Committee [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922626795 | Sabrina Yvette Kelley | Pathology | 801 W Sr 436 Ste 2005, Altamonte Springs, FL 32714-3053 | 2020-07-08 |
| 1407315575 | Aitor Lartitegui | Pathology | 15481 Sw 12th St Ste 303, Sunrise, FL 33326-1993 | 2019-03-18 |
| 1912479130 | Jean S Sanon | Pathology | 3020 High Ridge Rd Ste 600, Boynton Beach, FL 33426-8731 | 2018-12-28 |
| 1538645122 | Brandie Underwood | Pathology | 255 Se 7th Ave Ste 3, Crystal River, FL 34429-4848 | 2018-07-17 |
| 1407373368 | Cheska Lee Burleson | Pathology | 921 39th Ave Ne, Saint Petersburg, FL 33703-5924 | 2017-08-23 |
| 1356867048 | Kendall Ather Bryant | Pathology | 520 Baker St, Orlando, FL 32806 | 2017-08-15 |
| 1215329552 | Joseph Coscia | Pathology | 28 Bermuda Lake Dr, Palm Beach Gardens, FL 33418-4584 | 2015-02-24 |
| 1942600465 | Judith Mcmorris | Pathology | 4537 Winding River Way, Land O Lakes, FL 34639-5734 | 2014-09-03 |
| 1972756955 | Rafael Rodriguez | Pathology | 8004 Nw 154th St # 197, Miami Lakes, FL 33016-5814 | 2008-11-04 |
| 1861006983 | Tallahassee Covid Testing, LLC | Pathology | 220 Office Plz, Tallahassee, FL 32301-2808 | 2020-09-04 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on QUALITY CLINICAL LAB LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.