Active NPI
Diagnostic Cytology Laboratories Inc
- Clinical Medical Laboratory
- Granite City, IL
National Provider Identifier
1083778328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- DIAGNOSTIC CYTOLOGY LABORATORIES INC
- Practice address
- 2100 Madison Ave
Granite City, IL 62040-4701 - Phone
- (618) 798-3270
- Fax
- (317) 874-1440
- NPI assigned
- Dec 21, 2006
- Last updated
- May 5, 2008
- 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
- Mr. James A Bucher
- Title
- VP of Finance
- Phone
- (317) 874-1297
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
2100 Madison Ave
Granite City, IL 62040-4701
Mailing address
1520 Momentum PL
Chicago, IL 60689-5315
Phone (317) 874-1276
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100237800 | Medicaid | IN |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Anatomic Pathology & Clinical Pathology Physician
- Collinsville, IL
- NPI 1497858831
-
- Cytopathology Physician
- Terre Haute, IN
- NPI 1922118900
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166659200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1209945600000",
"number": "1083778328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1520 MOMENTUM PL",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606895315",
"telephone_number": "317-874-1276",
"fax_number": "317-874-1440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 MADISON AVE",
"city": "GRANITE CITY",
"state": "IL",
"postal_code": "620404701",
"telephone_number": "618-798-3270",
"fax_number": "317-874-1440"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DIAGNOSTIC CYTOLOGY LABORATORIES INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-21",
"last_updated": "2008-05-05",
"status": "A",
"authorized_official_last_name": "BUCHER",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "VP OF FINANCE",
"authorized_official_telephone_number": "317-874-1297",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100237800",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Granite City, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.