Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

MEDIVANCE SUPPLY LLC
NPI 1548174154
Clinical Medical Laboratory in Waldorf, MD

Active since September 30, 2026
2009 SAINT THOMAS DR APT 208, WALDORF, MD 20602(835) 658-9321 Get Directions Write a Review

NPPES record added: September 30, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Medivance Supply Llc NPPES

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

MEDIVANCE SUPPLY LLC (NPI 1548174154) is a healthcare organization registered as a clinical medical laboratory in Waldorf, Maryland and active in the NPI registry since September 2026. The organization lists Imran Kashif, Ceo, as its authorized official.

NPPES Registry Identity

NPI1548174154
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameMEDIVANCE SUPPLY LLC
Location Address2009 SAINT THOMAS DR APT 208Waldorf, MD 20602-2175
Mailing Address2009 Saint Thomas Dr Apt 208Waldorf, MD 20602-2175 · (835) 658-9321
Organization SubpartNo
Authorized OfficialImran KashifCeo · (835) 658-9321
Enumeration DateSeptember 30, 2026
NPPES CertifiedSeptember 30, 2026
✔ NPI 1548174154 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
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.
2009 SAINT THOMAS DR APT 208, Waldorf, MD 20602

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 Medivance Supply LLC's NPI number?

The NPI number for Medivance Supply LLC is 1548174154. It was assigned to this organization in the NPPES registry on September 30, 2026.

Where is Medivance Supply LLC located?

Medivance Supply LLC is located at 2009 Saint Thomas Dr Apt 208, Waldorf, MD 20602. The listed phone number is (835) 658-9321.

What is Medivance Supply 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 Medivance Supply LLC was last updated on September 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 days 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.