Pontiac Labs, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

23D0685754 Issued in MI

Legal business name

PONTIAC LABS, LLC

Practice address

461 W Huron St
Second Floor Lab
Pontiac, MI 48341-1601

Phone

(248) 857-7200

Fax

(248) 857-6905

NPI assigned

Oct 17, 2016

Organization subpart

No

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

Authorized official

Name

Scott Micheal Damron

Title

General Counsel

Phone

(678) 640-9664

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476662400000",
    "number": "1134670904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 W HURON ST",
            "address_2": "SECOND FLOOR LAB",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411601",
            "telephone_number": "248-857-7200",
            "fax_number": "248-857-6905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 W HURON ST",
            "address_2": "SECOND FLOOR LAB",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411601",
            "telephone_number": "248-857-7200",
            "fax_number": "248-857-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONTIAC LABS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A",
        "authorized_official_last_name": "DAMRON",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "MICHEAL",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "678-640-9664"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MI",
            "license": "23D0685754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pontiac General Hospital and Medical Centers
• Pontiac General Hospital and Medical Centers
• Pontiac General Hospital and Medical Centers
• Pontiac General Hospital Pharmacy Inc.
• Pontiac General Hospital Pharmacy Inc.
• Pontiac Osteopathic Hospital
• Pontiac Pharmacy LLC
• Christina Poponea, NP
• Elizabeth Popovski, M.D. M.SC.
• Angela M Porter, MD

• Clinical Medical Laboratory in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Clinical Medical Laboratory in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.