CLEAN SLATE LIVING
NPI 1265860522
Clinical Medical Laboratory in West Palm Beach, FL

Active since October 24, 2013
118 CANOE DR, WEST PALM BEACH, FL 33415(561) 270-2361 Get Directions Write a Review

NPPES record last updated: October 24, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Clinical Medical Laboratory

About CLEAN SLATE LIVING

This page provides the complete NPI Profile along with additional information for Clean Slate Living, a provider established in West Palm Beach, Florida operating as a Clinical Medical Laboratory. The healthcare provider is registered in the NPI registry with number 1265860522 assigned on October 2013. The practitioner's primary taxonomy code is 291U00000X with license number 10D2063192 (FL). The provider is registered as an organization and their NPI record was last updated 13 years ago. The authorized official of this NPI record is Angela Iacullo (Billing Director)

NPI
1265860522 Verify this NPI
Provider Name
CLEAN SLATE LIVING
Entity Type
Organization
Location Address
118 CANOE DR WEST PALM BEACH, FL 33415
Location Phone
(561) 270-2361
Mailing Address
118 CANOE DR WEST PALM BEACH, FL 33415
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-24-2013
Last Update Date
10-24-2013
Code Navigator

Establishments like Clean Slate Living are healthcare facilities that may perform a wide range of laboratory procedures, assisted by doctors and medical technologists. Laboratories can be categorized according to their function as common diagnostic labs or specialty labs that conduct specialized or confirmatory tests. Different clinical laboratories could specialize in clinical chemistry, clinical microbiology, hematology, serology, clinical microscopy, cytopathology, molecular biology, or public health. Please inquire directly with this provider to confirm their test menu.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinical Medical Laboratory

Taxonomy Code
291U00000X
Type
Laboratories
License No.
10D2063192
License State
FL
Taxonomy Description
(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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

ANGELA IACULLO

Authorized Official Title
BILLING DIRECTOR
Authorized Official Phone
(561) 270-2361

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1265860522, enumerated as an "organization" on October 24, 2013.

The provider is located at 118 CANOE DR WEST PALM BEACH, FL 33415 and the phone number is (561) 270-2361.

Clinical Medical Laboratory with taxonomy code 291U00000X.