NPI age
17 years
Enumerated 2009-04-07
● Active Type 2 · Organization
Subpart
Mod Lab
Mod Lab is 1 of 2082 clinical medical laboratory organizations in Texas.
Primary specialty
Clinical Medical Laboratory
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Oppenheimer
Owner
Last NPPES update
2009-04-07
Source: monthly bulk 2026-05
How this organization compares
Across 2082 active clinical medical laboratory providers in Texas.
NPI age
17 years
↑ 9 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2009 → 2026
2009-04Enumerated in NPPES
2009
2026
Where they practice
Primary practice location
4600 Greenville Avenue, Suite 240
Dallas, TX 752065037
Mailing address
Po Box 291209
Nashville, TN 372291209
Authorized official
Jonathan Oppenheimer
Owner
📞 6158740410
Specialties
-
Clinical Medical Laboratory Primary(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...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 45D1036151 | CLIA |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Prost Data Inc
Practice context
Single-site organization. Only one practice location on file.
Subpart of Prost Data Inc.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.