UNITED DIAGNOSTIC LABS, LLC NPI 1518624691

Clinical Medical Laboratory in Evanston, IL

NPI 1518624691 Organization Clinical Medical Laboratory CLIA Number 14D2244390 CLIA Certificate of Waiver

NPI Profile for UNITED DIAGNOSTIC LABS, LLC

United Diagnostic Labs, Llc is a provider established in Evanston, Illinois specializing in clinical medical laboratory. The NPI number of United Diagnostic Labs, Llc is 1518624691 and was assigned on November 2021. The practitioner's primary taxonomy code is 291U00000X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Mr. Stephan Mikel Erdelyi (President)

The CLIA number of United Diagnostic Labs, Llc is 14D2244390 registered as a "public health laboratory" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to United Diagnostic Labs, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1518624691

Provider NameUNITED DIAGNOSTIC LABS, LLC
Provider Location Address2515 GROSS POINT RD EVANSTON, IL 60201
Provider Mailing Address2521 GROSS POINT RD STE 1B EVANSTON, IL 60201
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date11-23-2021
Last Update Date11-29-2021


Primary Taxonomy

Taxonomy Code291U00000X
ClassificationClinical Medical Laboratory
TypeLaboratories
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.

Business Address

UNITED DIAGNOSTIC LABS, LLC
2515 GROSS POINT RD
EVANSTON, IL
ZIP 60201
Phone: (847) 530-4994

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Mailing Address

UNITED DIAGNOSTIC LABS, LLC
2521 GROSS POINT RD STE 1B
EVANSTON, IL
ZIP 60201
Phone: (312) 890-4340



Authorized Official

Authorized Official NameMR. STEPHAN MIKEL ERDELYI
Authorized Official TitlePRESIDENT
Authorized Official Phone(312) 890-4340

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1518624691 is:

CLIA Number14D2244390
Facility TypePUBLIC HEALTH LABORATORY
Certificate TypeCertificate of Waiver

NPI Validation Check Digit Calculation


The following table explains step by step the NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1518624691
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
25281228618
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 2 + 8 + 1 + 2 + 2 + 8 + 6 + 1 + 8 + 24 = 69
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 69 = 11

The NPI number 1518624691 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
United Diagnostic Labs, Llc is registered as an entity type code: 2. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.