Active NPI
L. Medicine Labs, LLC
- Clinical Medical Laboratory
- Berwyn, IL
National Provider Identifier
1053819722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- 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, 2024
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180710000474 | IL | Part B Supplier - Independent Clinical Laboratory | 6406102292 | Practice locations: Berwyn, IL |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D0688808 | L Medicine Labs, L L C | Accreditation | Jun 6, 2027 |
| 14D2238218 | L Medicine Labs, LLC - Waived Testing | Certificate of waiver | Sep 30, 2027 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- General Practice Physician
- Berwyn, IL
- NPI 1013415603
Member Of
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.