ELITE BIOMEDICAL LAB SERVICE NPI 1376116111

NPI Information

NPI: 1376116111
Provider Name: ELITE BIOMEDICAL LAB SERVICE
Classification: Technician, Pathology - 246RP1900X
Entity Type: Organization

Specialization: Phlebotomy

CLIA Number: 10D2166575

Address:
15202 NW 147TH DR STE 600
ALACHUA, FL
ZIP 32615
Phone: (386) 588-3230
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ELITE BIOMEDICAL LAB SERVICE is a phlebotomy technician pathology in Alachua, FL. ELITE BIOMEDICAL LAB SERVICE NPI is 1376116111. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

15202 NW 147TH DR STE 600
ALACHUA, FL
ZIP 32615-333
Phone: (386) 588-3230
Fax: (888) 480-7977

The provider's authorized official is Marjillian Williams .
The authorized official title is President and has the following contact phone number (386) 965-0313.

The CLIA number assigned to this NPI record is 10D2166575 - other - patient serv ctr with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/20/2021 and was last updated on 7/20/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	246RP1900X	Technician, Pathology	Phlebotomy			Yes
2	291U00000X	Clinical Medical Laboratory				No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	10D2166575	OTHER	FLORIDA	CLIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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