MDC Med Lab LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MDC MED LAB LLC

Practice address

1001 Vinings TRL SE
Smyrna, GA 30080-8638

Phone

(678) 933-9367

NPI assigned

Mar 8, 2023

Organization subpart

No

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

Authorized official

Name

Myia Canidate, LPNNPI 1780382010

Title

Owner

Phone

(678) 933-9367

Specialties & licenses 1

Addresses

Other names 1

• MDC Med Lab Doing business as

Practitioners 1

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

• Myia Canidate, LPN

  • Licensed Practical Nurse
  • Smyrna, GA
  • NPI 1780382010
  NPD Authorized official

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

{
    "created_epoch": "1678233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678233600000",
    "number": "1245930239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 VININGS TRL SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300808638",
            "telephone_number": "678-933-9367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 VININGS TRL SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300808638",
            "telephone_number": "678-933-9367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDC MED LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-08",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A",
        "authorized_official_last_name": "CANIDATE",
        "authorized_official_first_name": "MYIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-933-9367",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MDC Med Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nora McNeill, MD
• McPherson Health and Rehabilitation
• MCR Health, Inc.
• Kenneth L McRae, DC
• Janna Levisha McWilson, FNP-C
• Amon A Meadows, DMD
• Medcura Health, Inc.
• Medical Consultants Group
• Alejandro Medina, DC
• Andrew Medlock, ATC

• Clinical Medical Laboratory in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Clinical Medical Laboratory in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; 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.