IndividualActive
Ansenio Clark, MLT
NPI 1699517821 · Clinical Medical Laboratory · Montgomery, AL
Provider details
- NPI number
- 1699517821
- Entity type
- Individual
- Primary specialty
- Clinical Medical LaboratoryLaboratories
- Credential
- MLT
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Laboratories
Profile Score
Established profile(50/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1565 E Trinity Blvd
Montgomery, AL 36106-2897
Phone: (334) 440-4538
Street-level locationGet directions
Mailing address
1565 E Trinity Blvd
Montgomery, AL 36106-2897
Registry dates
- Enumerated
- 2024-06-10
- Last updated
- 2024-06-10
- Certified
- 2024-06-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.