NPIMap

Organization Active NPI

Terre Haute Medical Laboratory, Inc.

Doing business as Medlab

  • Clinical Medical Laboratory
  • Martinsville, IL
National Provider Identifier
1164749503
Registry record updated Apr 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
50000920A Issued in IN
Legal business name
TERRE HAUTE MEDICAL LABORATORY, INC.
Doing business as
Medlab
Practice address
890 Ridgelawn Rd
Suite a
Martinsville, IL 62442
Phone
(812) 244-0100
Fax
(812) 244-0096
NPI assigned
Apr 26, 2010
Last updated
Apr 26, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
TERRE HAUTE MEDICAL LABORATORY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 26, 2010

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

Authorized official

Name
Dr. William David Depond, M.D.NPI 1699741942
Title
President/Chief Medical Officer
Phone
(812) 244-0100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 50000920A IN Primary

Addresses

Primary practice location

890 Ridgelawn Rd
Suite a
Martinsville, IL 62442

Mailing address

634 Beech St
Terre Haute, IN 47804-2760
Phone (812) 244-0100

Other names 1

  • MEDLAB Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Terre Haute Laboratory Inc2 organizations share this tax ID, including this one
Part of
Terre Haute Laboratory Inc

Other organizations with this tax ID 1

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

Locations

890 E Ridgelawn Rd
Ste A
Martinsville, IL 62442
Phone (812) 244-0100

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272240000000",
    "number": "1164749503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 BEECH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478042760",
            "telephone_number": "812-244-0100",
            "fax_number": "812-244-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 RIDGELAWN RD",
            "address_2": "SUITE A",
            "city": "MARTINSVILLE",
            "state": "IL",
            "postal_code": "62442",
            "telephone_number": "812-244-0100",
            "fax_number": "812-244-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRE HAUTE MEDICAL LABORATORY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TERRE HAUTE MEDICAL LABORATORY, INC.",
        "enumeration_date": "2010-04-26",
        "last_updated": "2010-04-26",
        "status": "A",
        "authorized_official_last_name": "DEPOND",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT/CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "812-244-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IN",
            "license": "50000920A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDLAB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Martinsville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.