Medical Diagnostic Services

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MEDICAL DIAGNOSTIC SERVICES

Practice address

2400 South Street
Department of Pathology
Lafayette, IN 47903

Phone

(765) 446-7201

Fax

(765) 448-2921

NPI assigned

Feb 2, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mario R Contreras, MD

Title

Medical Director

Phone

(765) 446-7201

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225176233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18650 W CORPORATE DRIVE",
            "address_2": "SUITE 200",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "53045",
            "telephone_number": "262-641-5143",
            "fax_number": "262-641-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 SOUTH STREET",
            "address_2": "DEPARTMENT OF PATHOLOGY",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "47903",
            "telephone_number": "765-446-7201",
            "fax_number": "765-448-2921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL DIAGNOSTIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CONTRERAS",
        "authorized_official_first_name": "MARIO",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "765-446-7201",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nikki Louise Melchi, MA CCC SLP
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• Clinical Medical Laboratory in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Clinical Medical Laboratory in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.