Provider Demographics
NPI:1659322360
Name:U S LAB & RADIOLOGY LLC
Entity Type:Organization
Organization Name:U S LAB & RADIOLOGY LLC
Other - Org Name:US LABS - (US LABORATORY)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL/CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:CUOMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-786-8015
Mailing Address - Street 1:2 JONATHAN DR
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-5549
Mailing Address - Country:US
Mailing Address - Phone:508-583-2000
Mailing Address - Fax:508-895-9509
Practice Address - Street 1:2 JONATHAN DR
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-5549
Practice Address - Country:US
Practice Address - Phone:508-583-2000
Practice Address - Fax:438-427-2644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2253291U00000X
291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0009535OtherNEIGHBORHOOD HLTH PLANS
35-00001OtherEVERCARE
690006929OtherRAILROAD MEDICARE
RIUS16844Medicaid
NH30009485Medicaid
MA110025611AMedicaid
CT3098416Medicaid
800498OtherHARVARD/PILGRIM HEALTH
S028178OtherCHAMPUS - TRICARE
MATR0022OtherBLUE CROSS
000000021168OtherBOSTON MED HLTHNET PLAN
VT1011601Medicaid
RI2433-2OtherBLUE CROSS
803790OtherTUFTS HEALTH PLANS
NH3080795Medicaid
35-00040OtherUNITED HEALTHCARE - NEW E
ME153720000Medicaid
RI1659322360Medicaid
800498OtherHARVARD/PILGRIM HEALTH