NEOGENOMICS LABORATORIES INC (NPI# 1639793615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639793615 |
| Entity Type | Organization |
| Organization Name | NEOGENOMICS LABORATORIES INC |
| Practice Address |
15527 Cardamon Way Tustin CA 92782-1911 |
| Mailing Address |
31 Columbia Aliso Viejo CA 92656-1460 |
| Practice Telephone | 8667765907 |
| Practice Fax Number | 8884434153 |
| Mailing Telephone | 8667765907 |
| Mailing Fax Number | 8884434153 |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2020-06-25 |
| Authorized Official Name | KATHRYN BISOGNO MCKENZIE (CFO) |
| Authorized Official Telephone | 2397680600 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291900000X | Military Clinical Medical Laboratory | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CLIA | 05D2183172 | 01 |
| CA | CLINICAL AND PUBLIC HEALTH LABORATORY LICENSE | CLF90000729 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386268365 | Neogenomics Laboratories Inc | Clinical Medical Laboratory | 448 W Highland Ave, Sierra Madre, CA 91024-1710 | 2020-06-04 |
| 1437642717 | Neogenomics Laboratories Inc | Clinical Medical Laboratory | 29 Upper Riverdale Rd Sw Ste 140, Riverdale, GA 30274-2616 | 2018-06-11 |
| 1346645512 | Neogenomics Laboratories Inc | Specialist | 840 Cameron Dr, Pasadena, CA 91106 | 2014-10-29 |
| 1699176768 | Neogenomics Laboratories Inc | Clinical Medical Laboratory | 1 Jenner, Suite 180, Irvine, CA 92618 | 2014-09-09 |
| 1003245317 | Neogenomics Laboratories Inc | Clinical Medical Laboratory | 7256 S Sam Houston Pkwy W Ste 300, Houston, TX 77085 | 2013-11-06 |
| 1851664916 | Neogenomics Laboratories Inc | Clinical Medical Laboratory | 13005 N Telecom Pkwy Ste 104, Temple Terrace, FL 33637-0944 | 2012-02-20 |
| 1659641645 | Neogenomics Laboratories Inc | Pathology | 6455 Mission, West Bloomfield, MI 48324 | 2012-01-06 |
| 1710127279 | Neogenomics Laboratories Inc | Clinical Medical Laboratory | 9548 Topanga Canyon Blvd, Chatsworth, CA 91311-4011 | 2009-02-24 |
| 1154792695 | Neogenomics Laboratories Inc | Clinical Medical Laboratory | 2110 Rutherford Rd, Carlsbad, CA 92008-7328 | 2015-10-09 |
| 1912307547 | Neogenomics Laboratories Inc | Clinical Medical Laboratory | 30 E River Park Pl W, Suite 400, Fresno, CA 93720 | 2014-09-02 |
| Street Address |
15527 CARDAMON WAY |
| City | TUSTIN |
| State | CA |
| Zip Code | 92782-1911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548890528 | Christina Maria Clayton | Registered Nurse | 3100 Park Ave Apt 7-201, Tustin, CA 92782 | 2020-01-18 |
| 1447769963 | National Vision, Inc. | Technician/Technologist | 15020 Kensington Park Drive, J300, Tustin, CA 92782 | 2017-09-27 |
| 1487175410 | Vanson Dental Corporation | Dentist | 15160 Kensington Park Drive, Ste 610, Tustin, CA 92782 | 2017-06-29 |
| 1982133526 | Hee Eun Lee | Occupational Therapist | 2741 Dunstan Drive, Tustin, CA 92782 | 2017-06-07 |
| 1881129229 | Lydia Anna Bray | Pharmacist | 2102 Seminole, Tustin, CA 92782 | 2017-04-24 |
| 1427591577 | Charlie Huang | Internal Medicine | 15000 Kensington Park Dr Ste 250, Tustin, CA 92782 | 2016-11-21 |
| 1144672270 | Leiza Yamila Walia | Dentist | 15160 Kensington Park Dr Ste 610, Tustin, CA 92782 | 2016-07-13 |
| 1467831131 | Steven Yi Sun | Pediatrics | 15000 Kensington Park Dr, Tustin, CA 92782 | 2015-05-27 |
| 1639506405 | Medivan | Non-emergency Medical Transport (VAN) | 13800 Parkcenter Lane, Tustin, CA 92782 | 2013-10-10 |
| 1124266085 | Stacie Lynn Aragon | Counselor | 1 Hope Dr., Tustin, CA 92782 | 2009-01-30 |
| Find all providers in zip 92782 | ||||
| Taxonomy Code | 291900000X |
| Grouping | Laboratories |
| Classification | Military Clinical Medical Laboratory |
| A Department of Defense (DoD) medical clinical reference laboratory not associated with a DoD Hospital or DoD Clinic. An example is the Armed Forces Institute of Pathology. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851726590 | Mobile Cone Beam Ct Scan Inc | Military Clinical Medical Laboratory | 890 Eastlake Pkwy Ste 303, Chula Vista, CA 91914-4522 | 2013-09-12 |
| 1407009269 | Los Angeles County Probation Department | Military Clinical Medical Laboratory | 3606 W. Exposition Blvd, Los Angeles, CA 90016 | 2008-10-24 |
| 1194786509 | Fna Clinics of America, Inc. | Military Clinical Medical Laboratory | 3730 S Susan St, Santa Ana, CA 92704-8906 | 2006-03-28 |
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| 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.