Dejohn Medical Laboratories, Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

000363 Issued in PA

Legal business name

DEJOHN MEDICAL LABORATORIES, INC

Practice address

1570 Garrett Rd
Upper Darby, PA 19082-4500

Phone

(610) 626-2112

Fax

(610) 626-5923

NPI assigned

Jul 5, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Jean S Dejohn

Title

President/ Owner

Phone

(610) 626-2112

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003813189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 GARRETT RD",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190824500",
            "telephone_number": "610-626-2112",
            "fax_number": "610-626-5923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 GARRETT RD",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190824500",
            "telephone_number": "610-626-2112",
            "fax_number": "610-626-5923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEJOHN MEDICAL LABORATORIES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEJOHN",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT/ OWNER",
        "authorized_official_telephone_number": "610-626-2112",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PA",
            "license": "000363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007131880001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Upper Darby, PA
• Providers in Upper Darby, PA by specialty
• Clinical Medical Laboratory in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.