Organization Active NPI

L. Medicine Labs, LLC

  • Clinical Medical Laboratory
  • Berwyn, IL
National Provider Identifier
1053819722
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
L. MEDICINE LABS, LLC
Practice address
3231 Euclid Ave
Berwyn, IL 60402-3471
Phone
(708) 783-0737
NPI assigned
Jan 29, 2018
Last updated
Jan 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Authorized official

Name
Melissa Lukasick
Title
Regional Chief Financial Officer
Phone
(708) 216-5723

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

3231 Euclid Ave
Berwyn, IL 60402-3471

Mailing address

2160 S 1St Ave RM 1711
Maywood, IL 60153-3328
Phone (708) 216-8686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180710000474 IL Part B Supplier - Independent Clinical Laboratory 6406102292 Practice locations: Berwyn, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0688808L Medicine Labs, L L C3231 S Euclid Avenue, Berwyn, IL 60402AccreditationJun 6, 2027
14D2238218L Medicine Labs, LLC - Waived Testing3231 S Euclid Ave, Berwyn, IL 60402Certificate of waiverSep 30, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2160 S 1st Ave
Rm 1711
Maywood, IL 60153

NPI Registry JSON

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706054400000",
    "number": "1053819722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE RM 1711",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-8686",
            "fax_number": "708-216-8059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 EUCLID AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023471",
            "telephone_number": "708-783-0737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L. MEDICINE LABS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-29",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A",
        "authorized_official_last_name": "LUKASICK",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "REGIONAL CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "708-216-5723"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.