PROGRESSIVE MEDICAL LAB, LLC
NPI 1225432867
Clinical Medical Laboratory in Port Orange, FL

Active since October 10, 2014CLIA 10D2077051 · Certificate of Compliance
1690 DUNLAWTON AVE, SUITE 120, PORT ORANGE, FL 32127(386) 271-2273(386) 845-0221 Get Directions Write a Review

NPPES record last updated: October 10, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Progressive Medical Lab, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROGRESSIVE MEDICAL LAB, LLC (NPI 1225432867) is a healthcare organization registered as a clinical medical laboratory in Port Orange, Florida and active in the NPI registry since October 2014. The organization holds a CLIA Certificate of Compliance certificate valid through August 20, 2026 and lists Mayada Al Hussaini, Mgr, as its authorized official.

NPPES Registry Identity

NPI1225432867
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NamePROGRESSIVE MEDICAL LAB, LLC
Location Address1690 DUNLAWTON AVE, SUITE 120Port Orange, FL 32127-8979
Mailing Address345 Beville Rd, Suite 101South Daytona, FL 32119-2165
Fax(386) 845-0221
Organization SubpartNo
Authorized OfficialMayada Al HussainiMgr · (386) 795-4324
Enumeration DateOctober 10, 2014
NPI 1225432867 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
License Licensed in FL · 800027387
Definition

(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.

1690 DUNLAWTON AVE, Port Orange, FL 32127

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 10D2077051

Progressive Medical Lab LLC · S Daytona, FL
Active · expires Aug 20, 2026
CLIA Number10D2077051
Laboratory TypeIndependent
Certificate Effective DateAugust 21, 2024
Certificate Expiration DateAugust 20, 2026
Laboratory DirectorJames K. Allen
Laboratory Phone(386) 788-8000
Laboratory LocationProgressive Medical Lab LLC345 Beville Rd Ste 101a, S Daytona, FL 32119
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 10D1019929

Progressive Medical Research · Port Orange, FL
Active · expires Dec 3, 2027
CLIA Number10D1019929
Laboratory TypeOther
Certificate Effective DateDecember 4, 2025
Certificate Expiration DateDecember 3, 2027
Laboratory DirectorAlexander White
Laboratory Phone(386) 304-7070
Laboratory LocationProgressive Medical Research5111 Ridgewood Ave Ste 301, Port Orange, FL 32127
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2330780

Progressive Medical Research · Port Orange, FL
Active · expires Sep 22, 2027
CLIA Number10D2330780
Laboratory TypePhysician Office
Certificate Effective DateSeptember 23, 2025
Certificate Expiration DateSeptember 22, 2027
Laboratory DirectorBhanu Visvalingam
Laboratory Phone(386) 304-7070
Laboratory LocationProgressive Medical Research5111 S Ridgewood Ave Ste 101, Port Orange, FL 32127
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
1690 DUNLAWTON AVE, SUITE 220
PORT ORANGE, FL 32127
Specialist
1690 DUNLAWTON AVE, SUITE 220
PORT ORANGE, FL 32127
Social Worker (Clinical)
1690 DUNLAWTON AVE, SUITE 125
PORT ORANGE, FL 32127
General Acute Care Hospital
1690 DUNLAWTON AVE
PORT ORANGE, FL 32127
Counselor (Mental Health)
1690 DUNLAWTON AVE, 125
PORT ORANGE, FL 32127
Nurse Practitioner (Family)
1690 DUNLAWTON AVE, SUITE 120
PORT ORANGE, FL 32127
Nurse Anesthetist, Certified Registered
1690 DUNLAWTON AVE, SUITE 225
PORT ORANGE, FL 32127
Nurse Practitioner (Family)
1690 DUNLAWTON AVE
PORT ORANGE, FL 32127

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1225432867, enumerated as an "organization" on October 10, 2014.

The provider is located at 1690 DUNLAWTON AVE SUITE 120 PORT ORANGE, FL 32127 and the phone number is (386) 271-2273.

Clinical Medical Laboratory with taxonomy code 291U00000X.