PONTIAC LABS, LLC (NPI# 1134670904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134670904 |
| Entity Type | Organization |
| Organization Name | PONTIAC LABS, LLC |
| Practice Address |
461 W Huron St Second Floor Lab Pontiac MI 48341-1601 |
| Practice Telephone | 2488577200 |
| Practice Fax Number | 2488576905 |
| Mailing Telephone | 2488577200 |
| Mailing Fax Number | 2488576905 |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2016-10-17 |
| Authorized Official Name | SCOTT MICHEAL DAMRON (GENERAL COUNSEL) |
| Authorized Official Telephone | 6786409664 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 23D0685754 | MI | Laboratories |
| Street Address |
461 W HURON ST SECOND FLOOR LAB |
| City | PONTIAC |
| State | MI |
| Zip Code | 48341-1601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326019126 | Greyard R Lamm | Physician Assistant | 461 W Huron St, Pontiac, MI 48341-1601 | 2006-01-30 |
| 1578164091 | Mohmeduzber Molvi | Pharmacist | 461 W Huron St, Pontiac, MI 48341-1601 | 2020-11-02 |
| 1326655630 | Parth Anantbhai Patel | Family Medicine | 461 W Huron St, Pontiac, MI 48341-1601 | 2020-09-30 |
| 1295345445 | Krista Michele Hughes | Social Worker | 461 W Huron St, Pontiac, MI 48341-1601 | 2020-08-03 |
| 1437774841 | Ivy A Billones | Student in an Organized Health Care Education/Training Program | 461 W Huron St, Pontiac, MI 48341-1601 | 2020-06-11 |
| 1659995280 | Christopher Khachik Khoshoryan | Psychiatry & Neurology | 461 W Huron St, Pontiac, MI 48341-1601 | 2020-05-29 |
| 1992328686 | Marwa Alithawi | Student in an Organized Health Care Education/Training Program | 461 W Huron St, Pontiac, MI 48341-1601 | 2020-05-28 |
| 1225651821 | Honey Susan Paul | Student in an Organized Health Care Education/Training Program | 461 W Huron St, Pontiac, MI 48341 | 2020-05-19 |
| 1124640628 | Sandeep Kaur | Psychiatry & Neurology | 461 W Huron St, Pontiac, MI 48341-1601 | 2020-05-07 |
| 1679119838 | Raminder S Chhatwal | Psychiatry & Neurology | 461 W Huron St, Pontiac, MI 48341-1601 | 2019-11-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003415837 | Brittany Taylor Shandor | Registered Nurse | 32 East, 1200 Telegraph Rd, Pontiac, MI 48341 | 2020-10-22 |
| 1013534999 | Siddharth Chopra | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue Saint Joseph Mercy Oakland Hospit, Medical Education H-23, Pontiac, MI 48341 | 2020-06-26 |
| 1972120962 | Tara Elizabeth Bjorklund | Obstetrics & Gynecology | 44405 Woodward Ave - H23, St. Joseph Mercy Oakland - Gme Office, Pontiac, MI 48341 | 2020-06-25 |
| 1245856145 | Sarah Fatima | Student in an Organized Health Care Education/Training Program | St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue, Medical Education H-23, Pontiac, MI 48341 | 2020-06-17 |
| 1407471188 | Tyler Schaefer | Emergency Medical Technician, Basic | 32east 1200 N. Telegraph Rd., Pontiac, MI 48341 | 2020-06-09 |
| 1639793581 | Yash Kirankumar Varma | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue, Medical Education H-23, Pontiac, MI 48341 | 2020-06-05 |
| 1326661687 | Fnu Kavita | Student in an Organized Health Care Education/Training Program | C/o Shelly Casey, St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue Medical Education - H23, Pontiac, MI 48341 | 2020-05-21 |
| 1801452578 | Lolita Curry | Registered Nurse | 32 East 1200 Telegraph, Pontiac, MI 48341 | 2019-05-17 |
| 1619530060 | Priyadarshini Dixit | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue, St. Joseph Mercy Oakland Hospita, Pontiac, MI 48341 | 2019-04-20 |
| 1891358370 | Anil Gurpersaud | Student in an Organized Health Care Education/Training Program | 44405 Woodward Ave., St. Joseph Mercy Oakland, Pontiac, MI 48341 | 2019-04-19 |
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| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (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 body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730629312 | County of Oakland | Clinical Medical Laboratory | 1200 N Telegraph Rd, Building 32e, Pontiac, MI 48341-1032 | 2017-03-02 |
| 1215079462 | Oakland County Pathologists, Plc | Clinical Medical Laboratory | 50 N Perry St, Pontiac, MI 48342-2217 | 2007-02-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.