MAIN LINE CLINICAL LABORATORIES (NPI# 1578689865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578689865 |
| Entity Type | Organization |
| Organization Name | MAIN LINE CLINICAL LABORATORIES |
| Other Organization Name | MAIN LINE CLINICAL LABS - PAOLI HOSPITAL |
| Practice Address |
255 W Lancaster Ave Paoli PA 19301-1763 |
| Mailing Address |
950 E Haverford Rd Suite 110 Bryn Mawr PA 19010-3850 |
| Practice Telephone | 6102294100 |
| Mailing Telephone | 6105268480 |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. MICHAEL J BUONGIORNO (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 6105268480 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 000199 | PA | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 0015758270004 | 05 |
| Other Name | Type Code |
|---|---|
| Main Line Clinical Labs - Paoli Hospital | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750407045 | Main Line Clinical Laboratories | Clinical Medical Laboratory | 130 S Bryn Mawr Ave, Bryn Mawr, PA 19010-3121 | 2007-03-21 |
| 1669598959 | Main Line Clinical Laboratories | Clinical Medical Laboratory | 100 E Lancaster Ave, Wynnewood, PA 19096-3450 | 2007-03-21 |
| Street Address |
255 W LANCASTER AVE |
| City | PAOLI |
| State | PA |
| Zip Code | 19301-1763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679576144 | Victoriya K Hageney | Internal Medicine | 255 W Lancaster Ave, Paoli, PA 19301-1763 | 2005-05-27 |
| 1548874597 | Tam T Nguyen | Registered Nurse | 255 W Lancaster Ave, Paoli, PA 19301-1763 | 2020-09-06 |
| 1447864020 | Monica Anne Disipio | Nurse Practitioner | 255 W Lancaster Ave, Paoli, PA 19301-1763 | 2020-09-01 |
| 1194340786 | Natalie Toner | Physician Assistant | 255 W Lancaster Ave, Paoli, PA 19301-1763 | 2020-06-10 |
| 1932732138 | Cynthia Ayoki Okech | Registered Nurse | 255 W Lancaster Ave, Paoli, PA 19301-1763 | 2020-02-15 |
| 1013552983 | Ashley Diane Olley | Physician Assistant | 255 W Lancaster Ave, Paoli, PA 19301-1763 | 2019-11-14 |
| 1982247078 | Kelsy Kauffman | Physician Assistant | 255 W Lancaster Ave, Paoli, PA 19301-1763 | 2019-10-22 |
| 1245880707 | Melissa Ann Stefanosky | Physician Assistant | 255 W Lancaster Ave, Paoli, PA 19301-1763 | 2019-09-17 |
| 1558923425 | Cara Rose Weinstein | Genetic Counselor, MS | 255 W Lancaster Ave, Paoli, PA 19301-1763 | 2019-07-01 |
| 1780240887 | Rachel Michalek | Nurse Practitioner | 255 W Lancaster Ave, Paoli, PA 19301-1763 | 2019-05-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588280333 | Mary Callery | Physical Therapy Assistant | 16 Industrial Blvd., Ste. 101, Paoli, PA 19301 | 2020-06-17 |
| 1871097519 | Daniel Malloy-good | Social Worker | 45 Darby Rd Ste E4, Paoli, PA 19301 | 2018-03-19 |
| 1306354774 | Patricia Obilo-azandegbe | Counselor | 30 S Valley Rd Ste 101, Paoli, PA 19301 | 2018-01-18 |
| 1275992877 | Jessica Bernard | Physical Therapist | 40 Darby Rd Ste 1, Paoli, PA 19301 | 2016-02-11 |
| 1730576364 | Ushma Sheth | Podiatrist | 250 W Lancaster Ave Ste 225, Paoli, PA 19301 | 2015-04-21 |
| 1619371432 | Miriam Leslie Brewer | Physical Therapist | 195 W Lancaster Ave #3, Paoli, PA 19301 | 2014-10-22 |
| 1447665393 | Matthew Rementer | Podiatrist | 254 West Lancaster Ave, Paoli, PA 19301 | 2014-06-29 |
| 1720490915 | Edward Anthony Romero | Surgery | 255 W Lancaster Ave Ste 332, Paoli, PA 19301 | 2014-05-22 |
| 1285053421 | Jose Ethan Pulido | Urology | 2 Industrial Blvd Bldg C Ste 120, Paoli, PA 19301 | 2014-04-15 |
| 1093065849 | Kathleen M Canfield | Physician Assistant | 11 Industrial Blvd., Ste 204, Paoli Pointe Med. Office Bldg, Paoli, PA 19301 | 2012-09-19 |
| Find all providers in zip 19301 | ||||
| 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 |
|---|---|---|---|---|
| 1144830266 | Lifesensors, Inc. | Clinical Medical Laboratory | 271 Great Valley Pkwy, Malvern, PA 19355-1308 | 2020-08-04 |
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| 1548885676 | Frontage Laboratories, Inc. | Clinical Medical Laboratory | 700 Pennsylvania Dr, Exton, PA 19341-1129 | 2020-06-15 |
| 1003439191 | Testing Centers of America LLC | Clinical Medical Laboratory | 411 Swedeland Rd, King of Prussia, PA 19406-2716 | 2020-05-22 |
| 1760003313 | Anpac Technology Usa Co Ltd | Clinical Medical Laboratory | 727 Norristown Rd., 3 Spring House Innovation Park Suite 150, Lower Gywnedd, PA 19002 | 2020-05-05 |
| 1922635739 | Contamination Source Identification LLC | Clinical Medical Laboratory | 419 14th St, Huntingdon, PA 16652-1937 | 2020-03-24 |
| 1821623703 | Dj Lab LLC | Clinical Medical Laboratory | 2550 Brodhead Rd Ste 202, Bethlehem, PA 18020-8922 | 2020-03-11 |
| 1568095099 | Truchoice Diagnostics LLC | Clinical Medical Laboratory | 135 Midway Dr., Dubois, PA 15801-3857 | 2020-02-12 |
| 1134770720 | Central Pennsylvania Alliance Laboratory LLC | Clinical Medical Laboratory | 1803 Mount Rose Ave Ste C-3c4, York, PA 17403-3026 | 2019-09-25 |
| 1578125761 | Allergenis, LLC | Clinical Medical Laboratory | 2801 Sterling Dr, Hatfield, PA 19440-1956 | 2019-07-08 |
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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.