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PHOENIX MEDICAL LABORATORY NPI 1841280815


NPI Information

NPI: 1841280815
Provider Name: PHOENIX MEDICAL LABORATORY

Doing Business As: PATH LAB FORT MYERS

Classification: Clinical Medical Laboratory - 291U00000X
Entity Type: Organization
Address:
12701 COMMONWEALTH DR
SUITE 6
FORT MYERS, FL
ZIP 33913
Phone: (239) 768-0600
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PHOENIX MEDICAL LABORATORY is a clinical medical laboratory in Fort Myers, FL. 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. PHOENIX MEDICAL LABORATORY NPI is 1841280815. The provider is registered as an organization entity type.
The provider Is Doing Business As Path Lab Fort Myers.

The provider's business location address is:

12701 COMMONWEALTH DR
SUITE 6
FORT MYERS, FL
ZIP 33913-626
Phone: (239) 768-0600
Fax: (239) 768-0711

The provider's authorized official is Robert P Gasparini .
The authorized official title is President and has the following contact phone number (239) 768-0600.

The enumeration date for this NPI number is 10/21/2005 and was last updated on 5/29/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1291U00000XClinical Medical Laboratory8000017185FLORIDANo
2291U00000XClinical Medical LaboratoryCLIA10D1023653FLORIDANo
3291U00000XClinical Medical Laboratory8000019289FLORIDAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1E9147MEDICARE PINFLORIDA
2L9228MEDICARE PINFLORIDA
3L9266OTHERFLORIDABCBS FL

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: 11/14/2023

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