Healthcare Provider Details

I. General information

NPI: 1447437355
Provider Name (Legal Business Name): NEOGENOMICS LABORATORIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2008
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 COLUMBIA
ALISO VIEJO CA
92656
US

IV. Provider business mailing address

PO BOX 865365
ORLANDO FL
32886-4110
US

V. Phone/Fax

Practice location:
  • Phone: 866-776-5907
  • Fax: 888-443-4153
Mailing address:
  • Phone: 866-776-5907
  • Fax: 888-443-4153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License NumberCLF00350209
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License NumberCLF00351390
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License NumberCLF00351391
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License NumberCLF00350153
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License NumberCLF00350178
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number00350209
License Number StateCA
# 8
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License NumberCLF00011815
License Number StateCA

VIII. Authorized Official

Name: JEFFREY SCOTT SHERMAN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 866-776-5907