PROVIDENCE CLINICAL LAB, LLC
NPI 1346557022
Clinical Medical Laboratory in Somerdale, NJ

Active since September 01, 2010
317 AVA AVE, SOMERDALE, NJ 08083(856) 534-5367(856) 435-6067 Get Directions Write a Review

NPPES record last updated: September 7, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Providence Clinical Lab, Llc NPPES

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

PROVIDENCE CLINICAL LAB, LLC (NPI 1346557022) is a healthcare organization registered as a clinical medical laboratory in Somerdale, New Jersey and active in the NPI registry since September 2010. The organization lists Carol Joan Evans, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1346557022
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NamePROVIDENCE CLINICAL LAB, LLC
Location Address317 AVA AVESomerdale, NJ 08083-1603
Mailing AddressPo Box 213Somerdale, NJ 08083-0213 · (856) 534-5367 · Fax (856) 435-6067
Fax(856) 435-6067
Organization SubpartNo
Authorized OfficialCarol Joan EvansChief Executive Officer · (856) 534-5367
Enumeration DateSeptember 1, 2010
Last NPPES UpdateSeptember 7, 2023
NPI 1346557022 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
License Licensed in NJ · 1492292
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.
Also ListedHome HealthTaxonomy 251E00000X · License 1492292 (NJ)
317 AVA AVE, Somerdale, NJ 08083

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Providence Clinical Lab, LLC's NPI number?

The NPI number for Providence Clinical Lab, LLC is 1346557022. It was assigned to this organization in the NPPES registry on September 1, 2010.

Where is Providence Clinical Lab, LLC located?

Providence Clinical Lab, LLC is located at 317 Ava Ave, Somerdale, NJ 08083. The listed phone number is (856) 534-5367.

What is Providence Clinical Lab, LLC's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

When was this NPI record last updated?

The NPPES record for Providence Clinical Lab, LLC was last updated on September 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.