CMS-1500 Box 24J / 33a • NPI
1710477344
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
291U00000X (CMS 69)
CLIA-Certified Diagnostic Medical & Pathology Laboratory
Box 32 Service Location & ZIP+4
110B MEADOWLANDS PKWY STE 101, SECAUCUS, NJ, 07094-2308
✓ 9-Digit EDI 837 ZIP+4 (07094-2308)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1710477344 (ATVIVO LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1710477344 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | ATVIVO LLC |
| Plain-English Specialty | CLIA-Certified Diagnostic Medical & Pathology Laboratory NUCC Code: 291U00000X (Clinical Medical Laboratory) |
| Certifying / Licensing Body | CMS CLIA / College of American Pathologists (CAP) |
| Practice Location Address | 110B MEADOWLANDS PKWY STE 101, SECAUCUS, NJ, 07094-2308 |
| Practice Telephone / Fax | Tel: (844) 788-1478 |
| Administrative Mailing Address | 955 YONKERS AVE STE 19, YONKERS, NY, 10704-3063 |
| Enumeration & Last Sync | Enumerated: 2018-05-18 | CMS Record Updated: 2025-03-27 |
| Authorized Official | MOSHE KRAUS (COO) |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (291U00000X)
What Does Taxonomy Code 291U00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 291U00000X translates to:
"CLIA-Certified Diagnostic Medical & Pathology Laboratory"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ATVIVO LLC)
Typical CPT / Diagnostic Procedures:- Complete Blood Count (CBC) with Automated Differential (CPT 85025)
- Comprehensive Metabolic Panel (CMP), Fractionated Bilirubin & Hepatic Panel
- Quantitative Urine Culture & Colony Count (≥ 10⁵ CFU/mL) with Antibiotic Susceptibility
- HbA1c, Lipid Panel, TSH & High-Sensitivity Troponin Assays
- Diagnostic Reagent Panels & CLSI Antimicrobial Susceptibility Disks/MIC Cards
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
291U00000X — Clinical Medical LaboratoryPlain English: CLIA-Certified Diagnostic Medical & Pathology Laboratory | State: NY | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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