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Contact Information

CLINICAL LABORATORY ASSOCIATES, LLC
8118 GOOD LUCK RD
LANHAM, MD20706-3595
 Phone: 301-552-8118
 Fax: 301-498-3074
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for CLINICAL LABORATORY ASSOCIATES, LLC

NPI # 1477591121
LBN Legal business name CLINICAL LABORATORY ASSOCIATES, LLC
Authorized official ERIC WARGOTZ - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/03/2006
Last updated 01/25/2012 - About 14 years ago
Identifiers
MD Medicaid 260100100
DC Other 3437 BCBS GROUP PROVIDER #
MD Other W450CL BCBS GROUP PROVIDER #
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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