MID AMERICA CLINICAL LABORATORIES, LLC (NPI# 1699734640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699734640 |
| Entity Type | Organization |
| Organization Name | MID AMERICA CLINICAL LABORATORIES, LLC |
| Practice Address |
2560 N Shadeland Ave Indianapolis IN 46219-1705 |
| Mailing Address |
2560 N Shadeland Ave P.o. Box 19163 Indianapolis IN 46219-1705 |
| Practice Telephone | 3178031010 |
| Practice Fax Number | 3178030186 |
| Mailing Telephone | 3178031010 |
| Mailing Fax Number | 3178030186 |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2018-12-11 |
| Authorized Official Name | THOMAS KMETZ (CFO) |
| Authorized Official Telephone | 3178031010 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 15D0665318 | IN | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200188040A | 05 | |
| IN | CLIA | 15D0665318 | 01 |
| IN | 1681301 | CAP | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104885052 | Mid America Clinical Laboratories, LLC | Clinical Medical Laboratory | 1950 W 86th St, Suite 100, Indianapolis, IN 46260-2076 | 2006-03-20 |
| 1467866251 | Mid America Clinical Laboratories, LLC | Clinical Medical Laboratory | 10580 N Meridian St, Indianapolis, IN 46290-1028 | 2014-06-19 |
| 1699189704 | Mid America Clinical Laboratories, LLC | Clinical Medical Laboratory | 3630 Guion Rd, Indianapolis, IN 46222-1616 | 2014-06-17 |
| 1326451113 | Mid America Clinical Laboratories, LLC | Clinical Medical Laboratory | 911 N Shelby St, Salem, IN 47167-2304 | 2014-06-09 |
| 1336552587 | Mid America Clinical Laboratories, LLC | Clinical Medical Laboratory | 2015 Jackson St, Anderson, IN 46016-4337 | 2014-06-05 |
| 1023421310 | Mid America Clinical Laboratories, LLC | Clinical Medical Laboratory | 1206 E National Ave, Brazil, IN 47834-2718 | 2014-06-04 |
| 1669885950 | Mid America Clinical Laboratories, LLC | Clinical Medical Laboratory | 1600 23rd St, Bedford, IN 47421-4704 | 2014-06-04 |
| 1477966760 | Mid America Clinical Laboratories, LLC | Clinical Medical Laboratory | 1331 S A St, Elwood, IN 46036-1942 | 2014-06-04 |
| 1477966778 | Mid America Clinical Laboratories, LLC | Clinical Medical Laboratory | 412 N Monroe St, Williamsport, IN 47993-1049 | 2014-06-04 |
| 1831502129 | Mid America Clinical Laboratories, LLC | Clinical Medical Laboratory | 3700 Washington Ave, Evansville, IN 47714-0542 | 2014-06-04 |
| Street Address |
2560 N SHADELAND AVE |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46219-1705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992781728 | Thomas W. Draper | Pathology | 2560 N Shadeland Ave, Suite A, Indianapolis, IN 46219-1705 | 2005-12-22 |
| 1053742320 | Mid America Clinical Laboratories, LLC | Clinical Medical Laboratory | 2560 N Shadeland Ave, Indianapolis, IN 46219-1705 | 2013-12-11 |
| 1598192031 | Mid America Clinical Laboratories, LLC | Clinical Medical Laboratory | 2560 N Shadeland Ave, Indianapolis, IN 46219-1705 | 2013-09-30 |
| 1932403946 | Andrew Thomas Schubeck | Pathology | 2560 N Shadeland Ave, Suite A, Indianapolis, IN 46219-1705 | 2011-01-05 |
| 1992948988 | Angela Maria Bookwalter Collie | Pathology | 2560 N Shadeland Ave, Suite A, Indianapolis, IN 46219-1705 | 2009-04-07 |
| 1386803179 | Michael Joseph Morton | Pathology | 2560 N Shadeland Ave, Suite A, Indianapolis, IN 46219-1705 | 2008-06-05 |
| 1386711711 | Modeson-samuel Banez Ferrer | Pathology | 2560 N Shadeland Ave, Ste A, Indianapolis, IN 46219-1705 | 2006-11-29 |
| 1942374517 | Ameripath Indianapolis PC | Pathology | 2560 N Shadeland Ave, Suite A, Indianapolis, IN 46219-1706 | 2006-11-17 |
| 1316919079 | Ameripath Indianapolis PC | Pathology | 2560 N Shadeland Ave, Suite A, Indianapolis, IN 46219-1706 | 2006-02-06 |
| 1013994375 | Marvin E. Melton | Pathology | 2560 N Shadeland Ave, Suite A, Indianapolis, IN 46219-1705 | 2005-12-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518571157 | Kara Kathryn Berning | Dietitian, Registered | 2040 N. Shadeland Ave, Suite 130, Indianapolis, IN 46219 | 2020-09-01 |
| 1780223750 | Erin Cannon | Specialist | 1543 N Post Rd, Indianapolis, IN 46219 | 2019-12-23 |
| 1073151239 | Tanicka Elizabeth Word | Behavior Technician | 6635 E 21st Street, West Building, Indianapolis, IN 46219 | 2019-12-18 |
| 1790322527 | Arlington Westend Dental LLC | Dentist | 5900 E 10th St, Indianapolis, IN 46219 | 2019-11-27 |
| 1336645985 | Lynell Westbrook Gates | Counselor | 1311 N Arlington Ave Ste 102, Indianapolis, IN 46219 | 2018-04-03 |
| 1861991689 | Comfort Dental LLC | Clinic/Center | 8151 E 21st St., Indianapolis, Indianapolis, IN 46219 | 2018-02-07 |
| 1467811570 | Fresenius Medical Care Indiana, LLC | Clinic/Center | 6701 E 21st St, Indianapolis, IN 46219 | 2016-02-17 |
| 1992197289 | Casey Baker | Physician Assistant | 1500 N Ritter Ave (medical Associates, LLP), Indianapolis, IN 46219 | 2015-02-24 |
| 1811398407 | Adam Romesser | Pharmacist | 8907 E. 10th St., Indianapolis, IN 46219 | 2014-09-15 |
| 1225448673 | Justin Stauffer | Pharmacist | 5903 E Pleasant Run Parkway North Dr, Indianapolis, IN 46219 | 2014-05-06 |
| Find all providers in zip 46219 | ||||
| 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 |
|---|---|---|---|---|
| 1588226864 | Accutreat LLC | Clinical Medical Laboratory | 9661 Crosspoint Blvd, Indianapolis, IN 46256 | 2019-07-08 |
| 1720409154 | Patients Choice Laboratories of Indiana, LLC | Clinical Medical Laboratory | 7026 Corporate Dr, Indianapolis, IN 46278-1937 | 2014-01-03 |
| 1427396480 | Labverdict | Clinical Medical Laboratory | 2311 Duke St, Indianapolis, IN 46205-2239 | 2013-01-26 |
| 1649518135 | Phlebotomy Connection, LLC | Clinical Medical Laboratory | 3806 West 86th St, Suite B, Indianapolis, IN 46268 | 2013-01-18 |
| 1194033092 | State of Indiana Auditor of State | Clinical Medical Laboratory | 550 W 16th St Ste B, Indianapolis, IN 46202-2218 | 2010-09-14 |
| 1265755136 | Indiana State Department of Health | Clinical Medical Laboratory | 550 W 16th Street, Sutie B, Indianapolis, IN 46202-7804 | 2010-03-08 |
| 1588996870 | Martin Center, Inc. | Clinical Medical Laboratory | 3549 N College Ave, Indianapolis, IN 46205-3733 | 2010-02-11 |
| 1558595124 | In Sook Seo | Clinical Medical Laboratory | 1555 E 79th St, Indianapolis, IN 46240-2702 | 2009-05-11 |
| 1235389297 | Indiana University School of Medicine, Department of Pathology and Lab | Clinical Medical Laboratory | 635 Barnhill Dr # Ms 128, Indianapolis, IN 46202-5126 | 2008-09-26 |
| 1770732679 | Pa Labs LLC | Clinical Medical Laboratory | 7750 Zionsville Rd Ste 450, Indianapolis, IN 46268-2195 | 2008-09-16 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46219 |
Please comment or provide details below to improve the information on MID AMERICA CLINICAL LABORATORIES, LLC.
| 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.