NPIMap

Organization Active NPI

Michigan Dept of Health and Human Services

  • Clinical Medical Laboratory
  • Lansing, MI
National Provider Identifier
1215065883
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
23D0650909 Issued in MI
Legal business name
MICHIGAN DEPT OF HEALTH AND HUMAN SERVICES
Practice address
3350 N Martin Luther King Jr Blvd
State Laboratory
Lansing, MI 48906-2978
Phone
(517) 335-8063
Fax
(517) 335-8051
NPI assigned
Mar 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Authorized official

Name
Dr. Sandip Shah, PHD
Title
Laboratory Director
Phone
(517) 335-8063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 23D0650909 MI Primary

Addresses

Primary practice location

3350 N Martin Luther King Jr Blvd
State Laboratory
Lansing, MI 48906-2978

Mailing address

3350 N Martin Luther King Jr Blvd
State Laboratory
Lansing, MI 48906-2978
Phone (517) 335-8063

Other identifiers 1

IdentifierTypeStateIssuer
4778402MedicaidMI

Other names 1

  • State Laboratory Doing business as

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
23D0650909Michigan Department of Health and Human Services3350 N Martin L King Jr Blvd, Lansing, MI 48906AccreditationAug 6, 2027

National Provider Directory

National Provider Directory
Tax ID family
State of Mi Management15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

3350 N Martin Luther King Jr Blvd
Lansing, MI 48906
Phone (517) 335-8063

Interoperability endpoints

  • FHIR API: https://api.interopstation.com/mdhhs/fhir

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598313600000",
    "number": "1215065883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 N MARTIN LUTHER KING JR BLVD",
            "address_2": "STATE LABORATORY",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489062978",
            "telephone_number": "517-335-8063",
            "fax_number": "517-335-8051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 N MARTIN LUTHER KING JR BLVD",
            "address_2": "STATE LABORATORY",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489062978",
            "telephone_number": "517-335-8063",
            "fax_number": "517-335-8051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN DEPT OF HEALTH AND HUMAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "SANDIP",
        "authorized_official_title_or_position": "LABORATORY DIRECTOR",
        "authorized_official_telephone_number": "517-335-8063",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MI",
            "license": "23D0650909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4778402",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "State Laboratory",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "State Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; 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.