NPI Details
SOPHORA DIAGNOSTIC LAB INC is a clinical medical laboratory in Jamaica, NY. The provider is (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. SOPHORA DIAGNOSTIC LAB INC NPI is 1669451563. The provider is registered as an organization entity type.
The provider's business location address is:
79-18 164 ST
JAMAICA, NY
ZIP 11432
Phone: (718) 969-2884
Fax: (718) 969-2576
The provider's authorized official is Mikhail I Kantius .
The authorized official title is President Owner and has the following contact phone number (718) 969-2884.
The CLIA number assigned to this NPI record is 33D0691954 - independent with a certificate type of Certificate of Compliance.
The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.
- Pathology examination of tissue using a microscope, intermediate complexity (HCPCS:88305)
- Special stained specimen slides to identify organisms including interpretation and report (HCPCS:88312)
- Pathology examination of tissue using a microscope, moderately low complexity (HCPCS:88304)
The enumeration date for this NPI number is 1/10/2006 and was last updated on 8/22/2007.
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 | 291U00000X | Clinical Medical Laboratory | | | | Yes |
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 | 00236 | MEDICARE PIN | NEW YORK | |
