Clinical Medical Laboratory in Theodore, AL

NPI 1598142895 Organization Clinical Medical Laboratory CLIA Number 01D2093765 CLIA Certificate of Accreditation


Synergy Laboratories Inc is a provider established in Theodore, Alabama specializing in clinical medical laboratory. The NPI number of Synergy Laboratories Inc is 1598142895 and was assigned on May 2015. The practitioner's primary taxonomy code is 291U00000X with license number 01D2093765 (AL). The provider is registered as an organization and their NPI record was last updated 6 years ago. The authorized official of this NPI record is Bradrick O Pitts (Ceo)

The CLIA number of Synergy Laboratories Inc is 01D2093765 registered as a "other" facility with a CLIA Certificate of Accreditation. This is a CLIA certificate is issued to Synergy Laboratories Inc on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.



Provider Location Address5570 RANGELINE RD THEODORE, AL 36619
Provider Mailing Address5570 RANGELINE RD THEODORE, AL 36619
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date05-06-2015
Last Update Date02-19-2016

Primary Taxonomy

Taxonomy Code291U00000X
ClassificationClinical Medical Laboratory
License No.01D2093765
License StateAL
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

ZIP 36619
Phone: (251) 662-9760
Fax: (251) 272-1979

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Mailing Address

ZIP 36619
Phone: (251) 662-9760
Fax: (251) 272-1979

Authorized Official

Authorized Official Name BRADRICK O PITTS
Authorized Official TitleCEO
Authorized Official Phone(678) 250-9370

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 1598142895 is:

CLIA Number01D2093765
Facility TypeOTHER
Certificate TypeCertificate of Accreditation

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
The code describing 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.