MAIN LINE CLINICAL LABORATORIES (NPI# 1669598959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669598959 |
| Entity Type | Organization |
| Organization Name | MAIN LINE CLINICAL LABORATORIES |
| Other Organization Name | MAIN LINE CLINICAL LABS - LANKENAU |
| Practice Address |
100 E Lancaster Ave Wynnewood PA 19096-3450 |
| 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 | 000242 | PA | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 0015758270006 | 05 |
| Other Name | Type Code |
|---|---|
| Main Line Clinical Labs - Lankenau | 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 |
| 1578689865 | Main Line Clinical Laboratories | Clinical Medical Laboratory | 255 W Lancaster Ave, Paoli, PA 19301-1763 | 2007-03-21 |
| Street Address |
100 E LANCASTER AVE |
| City | WYNNEWOOD |
| State | PA |
| Zip Code | 19096-3450 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003819079 | Robert D. Smink Jr. | Surgery | 100 E Lancaster Ave, Wynnewood, PA 19096-3450 | 2005-05-24 |
| 1164021713 | Clay Johnson | Physician Assistant | 100 E Lancaster Ave, Wynnewood, PA 19096-3450 | 2020-10-23 |
| 1447858725 | Anthony Montello | Nurse Anesthetist, Certified Registered | 100 E Lancaster Ave, Wynnewood, PA 19096-3450 | 2020-10-09 |
| 1982216107 | Delaware Valley I.d. Associates, P.C. | Clinic/Center | 100 E Lancaster Ave, Mob East 556, Wynnewood, PA 19096 | 2020-08-19 |
| 1831708551 | Farouk Al Chami | Student in an Organized Health Care Education/Training Program | 100 E Lancaster Ave, Wynnewood, PA 19096-3450 | 2020-07-28 |
| 1225647944 | Farah Olleik | Internal Medicine | 100 E Lancaster Ave, Wynnewood, PA 19096-3450 | 2020-07-28 |
| 1134738859 | Talar Telvizian | Student in an Organized Health Care Education/Training Program | 100 E Lancaster Ave, Wynnewood, PA 19096-3450 | 2020-07-28 |
| 1962011833 | Fares Sukhon | Student in an Organized Health Care Education/Training Program | 100 E Lancaster Ave, Wynnewood, PA 19096-3450 | 2020-07-27 |
| 1700494028 | Aviad Lavian | Internal Medicine | 100 E Lancaster Ave, Wynnewood, PA 19096-3450 | 2020-07-22 |
| 1700404472 | Dalia Amrom | Internal Medicine | 100 E Lancaster Ave, Wynnewood, PA 19096-3450 | 2020-07-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831727866 | Jeffrey Glenn Johnston | Hospitalist | Lankenau Medical Center. 100 E Lancaster Ave, Wynnewood, PA 19096 | 2020-03-27 |
| 1326500331 | Maitri Pancholy | Student in an Organized Health Care Education/Training Program | Annenberg Center, G-10, 100 Lancaster Avenue, Wynnewood, PA 19096 | 2019-04-01 |
| 1306355987 | Karie Elizabeth Melton | Social Worker | 250 E Wynnewood Rd E12, Wynnewood, PA 19096 | 2017-09-26 |
| 1518320662 | Kaitlyn Kennard | Surgery | 100 Lancaster Ave Mob South Suite 422, Wynnewood, PA 19096 | 2016-04-05 |
| 1366814675 | Linda Elkins | Counselor | 543 Haverford Rd, Wynnewood, PA 19096 | 2015-10-26 |
| 1619347655 | Tessa Kovick | Registered Nurse | 100 E Lancaster Ave Ste 114, Wynnewood, PA 19096 | 2015-10-02 |
| 1922476415 | Amy Lenrow | Skilled Nursing Facility | 1510 Powder Mill Lane, Wynnewood, PA 19096 | 2015-09-14 |
| 1144602855 | Casey Dajao | Internal Medicine | 100 E Lancaster Ave Ste 140, Wynnewood, PA 19096 | 2015-06-18 |
| 1649666223 | Benjamin Larson | Internal Medicine | 100 E Lancaster Ave Ste B11, Wynnewood, PA 19096 | 2015-04-10 |
| 1760873285 | Kathleen Gilmartin | Nurse Practitioner | 100 East Lancaster Ave, Wynnewood, PA 19096 | 2015-02-06 |
| Find all providers in zip 19096 | ||||
| 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 |
|---|---|---|---|---|
| 1922486216 | Sphinx Diagnostics, LLC | Clinical Medical Laboratory | 106 N. Powell Ave., Ste 206, Wynnewood, OK 73098 | 2015-05-07 |
| 1841671708 | Wynnewood Diagnostic Laboratory | Clinical Medical Laboratory | 116 E Robert S Kerr Blvd, Wynnewood, OK 73098-6621 | 2015-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144830266 | Lifesensors, Inc. | Clinical Medical Laboratory | 271 Great Valley Pkwy, Malvern, PA 19355-1308 | 2020-08-04 |
| 1891312179 | Allora Laboratory, LLC | Clinical Medical Laboratory | 405 Saint Johns Church Rd Ste 104, Camp Hill, PA 17011-5739 | 2020-07-02 |
| 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.