CAROLINA MEDICAL LAB GROUP INC. (NPI# 1992700124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992700124 |
| Entity Type | Organization |
| Organization Name | CAROLINA MEDICAL LAB GROUP INC. |
| Practice Address |
1815 Back Creek Dr Charlotte NC 28213-2159 |
| Practice Telephone | 7045988818 |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2009-07-27 |
| Authorized Official Name | MR. OSAMA IDLIBI (VICE PRESIDENT) |
| Authorized Official Telephone | 7045988818 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 34D0946272 | NC | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7001214 | 05 |
| Street Address |
1815 BACK CREEK DR |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28213-2159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962407189 | Omar Idlibi | Pathology | 1815 Back Creek Dr, Charlotte, NC 28213-2159 | 2005-06-15 |
| 1750802344 | The Snf Group, Pllc | Family Medicine | 1815 Back Creek Dr, Charlotte, NC 28213-2159 | 2017-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194288241 | Tonya Denise Farmer | Nurse Practitioner | 620 Tom Hunter Road, Charlotte, NC 28213 | 2019-04-06 |
| 1447743331 | April Neville | Counselor | 2442 Ryerson Ct, Charlotte, NC 28213 | 2018-06-14 |
| 1194234328 | Specialized Health Care Services | Case Management | 2750 E. Wt Harris Blvd, Suite 128, Charlotte, NC 28213 | 2017-09-19 |
| 1871016816 | Monarch | Occupational Therapist | 1810 Back Creek Drive, Charlotte, NC 28213 | 2017-07-21 |
| 1609306778 | Mackenzie Cashman Precht | Physician Assistant | 2225 E W T Harris Blvd Unit B, Charlotte, NC 28213 | 2017-06-12 |
| 1861939118 | Nensi Pandya | Pharmacist | 10227 University City Blvd, Charlotte, NC 28213 | 2017-01-25 |
| 1952721458 | Morgan Washington | Specialist/Technologist | 2336 Comfrey Court, Charlotte, NC 28213 | 2014-04-23 |
| 1992132393 | Midway Healthcare | Home Health | 6003 Dovetree Lane Suite D, Charlotte, NC 28213 | 2013-09-30 |
| 1932445178 | Zachary Gachogu Kariuki | Counselor | 10417 Round Leaf Drive, Charlotte, NC 28213 | 2012-12-17 |
| 1962747675 | Crystal Cherie Simmons | Counselor | 13724 Riding Hill Ave, Charlotte, NC 28213 | 2012-12-06 |
| Find all providers in zip 28213 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295341006 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 125 Queens Rd Ste 370, Charlotte, NC 28204-3215 | 2020-09-17 |
| 1538716113 | Karany's Veracity Company,llc | Clinical Medical Laboratory | 1816 E Arbors Dr Ste 440, Charlotte, NC 28262-2666 | 2019-08-20 |
| 1720546468 | Southeast Pathology Consultants, Inc. | Clinical Medical Laboratory | 1815 Back Creek Dr Ste 100, Charlotte, NC 28213-2159 | 2019-03-12 |
| 1679060222 | 1st Stop Labs LLC | Clinical Medical Laboratory | 4920 Albemarle Rd, Charlotte, NC 28205-6618 | 2018-04-19 |
| 1700399656 | David Farache | Clinical Medical Laboratory | 300 Billingsley Rd Ste 107, Charlotte, NC 28211-1084 | 2017-11-14 |
| 1063945582 | Bpolloni Consulting | Clinical Medical Laboratory | 11709 Fruehauf Drive, Suite 105 & 106, Charlotte, NC 28273 | 2017-04-11 |
| 1639541295 | Highline Labs, LLC | Clinical Medical Laboratory | 5900 Northwoods Business Parkway, Suite K, Charlotte, NC 28269-5747 | 2015-10-22 |
| 1134512429 | Anchore Laboratories, Inc | Clinical Medical Laboratory | 3635 Mount Holly Huntersville Rd, Charlotte, NC 28216-8628 | 2015-03-10 |
| 1326430091 | Captiva Lab | Clinical Medical Laboratory | 3300 International Airport Drive, Suite 100, Charlotte, NC 28208-5799 | 2015-03-04 |
| 1578960274 | Direct Access Lab, LLC | Clinical Medical Laboratory | 4822 Albemarle Road, Suite 110, Charlotte, NC 28205-6621 | 2014-11-24 |
| Find all providers in CHARLOTTE | ||||
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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.