NPIMap

Organization Active NPI

Toledo Clinic Incorporated

  • Clinical Medical Laboratory
  • Toledo, OH
National Provider Identifier
1114079167
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
TOLEDO CLINIC INCORPORATED
Practice address
4235 Secor Rd
Toledo, OH 43623-4231
Phone
(419) 479-5445
NPI assigned
Jan 18, 2007
Last updated
Jan 12, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
TOLEDO CLINIC INCORPORTATEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Authorized official

Name
Tom Sylak
Title
Chief Operating Officer
Phone
(419) 473-3561

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

4235 Secor Rd
Toledo, OH 43623-4231

Mailing address

4235 Secor Rd
Toledo, OH 43623-4231
Phone (419) 479-5445

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080506000244 OH Part B Supplier - Independent Clinical Laboratory 5698673382 Practice locations: Sylvania, OH; Toledo, OH

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
36D0332588Toledo Clinic Inc4235 Secor Road Toledo Clinic Lab B1, LL, Toledo, OH 43623AccreditationApr 2, 2027
36D1097051Toledo Clinic Inc Outpatient Surgery Center4235 Secor Road Building 2, Toledo, OH 43623Certificate of waiverMar 16, 2027

National Provider Directory

National Provider Directory
Tax ID family
David M Merrell30 organizations share this tax ID, including this one
Part of
David M Merrell

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

Practitioners & affiliated clinicians

Practitioners 218

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.

View all 218

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705017600000",
    "number": "1114079167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234231",
            "telephone_number": "419-479-5445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234231",
            "telephone_number": "419-479-5445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOLEDO CLINIC INCORPORATED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TOLEDO CLINIC INCORPORTATED",
        "enumeration_date": "2007-01-18",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A",
        "authorized_official_last_name": "SYLAK",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "419-473-3561"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.