St. Jude Laboratories LLC
Clinical Medical Laboratory in Columbia, MD. Organization (NPI-2).
NPI number1083172043
StatusActive
Last updated in NPPESAug 29, 2025
Details
- NPI
- 1083172043
- Entity type
- Organization (NPI-2)
- Legal business name
- St. Jude Laboratories LLC
- Organization subpart
- No
- Enumeration date
- Mar 8, 2019
- Certification date
- Aug 29, 2025
- Last updated
- Aug 29, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 291U00000X | Clinical Medical Laboratory | – | – | Yes |
Practice location
8950 Route 108 Ste 121Columbia, MD 21045-2150
Phone 410-862-8162 · Fax 410-630-7474
Mailing address
8950 Route 108 Ste 121Columbia, MD 21045-2150
Phone 410-862-8162 · Fax 410-630-7474
Other practice locations
9017 Mendenhall Ct Ste D
Columbia, MD 21045-4732
Columbia, MD 21045-4732
Phone 410-862-8162 · Fax 410-630-7474
Authorized official
Bose Kalampanayil
Owner
4108844120
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