Organization Active NPI

Om Diagnostic Laboratories Inc.

  • Clinical Medical Laboratory
  • Norwood, MA
National Provider Identifier
1053984807
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
OM DIAGNOSTIC LABORATORIES INC.
Practice address
128 Carnegie Row Ste 108
Norwood, MA 02062-5162
Phone
(508) 873-6257
NPI assigned
Jul 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Authorized official

Name
Madhukar Sharma
Title
Ceo
Phone
(508) 873-6257

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

128 Carnegie Row Ste 108
Norwood, MA 02062-5162

Mailing address

128 Carnegie Row Ste 108
Norwood, MA 02062-5162
Phone (508) 873-6257

Other identifiers 2

IdentifierTypeStateIssuer
110178312AMedicaidMA
22D2227255OtherCLIA ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210826000489 MA Part B Supplier - Independent Clinical Laboratory 3173928348 Practice locations: Norwood, MA

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
22D2227255Om Diagnostic Laboratories, Inc128 Carnegie Row, Norwood, MA 02062AccreditationMay 3, 2028

National Provider Directory

National Provider Directory

Locations

128 Carnegie Row
Ste 108
Norwood, MA 02062
Phone (508) 873-6257

NPI Registry JSON

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757894400000",
    "number": "1053984807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 CARNEGIE ROW STE 108",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020625162",
            "telephone_number": "508-873-6257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 CARNEGIE ROW STE 108",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020625162",
            "telephone_number": "508-873-6257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OM DIAGNOSTIC LABORATORIES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-20",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "MADHUKAR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "508-873-6257"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110178312A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA ID",
            "identifier": "22D2227255",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwood, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; 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.