NPIMap

Organization Active NPI

Indiana State Department of Health

  • Clinical Medical Laboratory
  • Indianapolis, IN
National Provider Identifier
1265755136
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
INDIANA STATE DEPARTMENT OF HEALTH
Practice address
550 W 16TH Street
Sutie B
Indianapolis, IN 46202-7804
Phone
(317) 921-5500
Fax
(317) 927-7801
NPI assigned
Mar 8, 2010
Organization subpart
Yes
Parent organization
INDIANA STATE DEPARTMENT OF HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Authorized official

Name
Dr. Lixia Liu, PH.D., D(ABMM)
Title
Laboratory Director
Phone
(317) 921-8509

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

550 W 16TH Street
Sutie B
Indianapolis, IN 46202-7804

Mailing address

550 W 16TH Street
Sutie B
Indianapolis, IN 46202-7804
Phone (317) 921-5500

Other identifiers 2

IdentifierTypeStateIssuer
15D0662599OtherCLIA
(LPI):100284680AMedicaidIN

Other names 2

  • Indiana Department of Health State Laboratory Doing business as
  • Indiana State Health Laboratory Other name

National Provider Directory

National Provider Directory
Tax ID family
State of Indiana Auditor of State32 organizations share this tax ID, including this one
Part of
State of Indiana Auditor of State

Other organizations with this tax ID 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1268006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1265755136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 W 16TH STREET",
            "address_2": "SUTIE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462027804",
            "telephone_number": "317-921-5500",
            "fax_number": "317-927-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W 16TH STREET",
            "address_2": "SUTIE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462027804",
            "telephone_number": "317-921-5500",
            "fax_number": "317-927-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA STATE DEPARTMENT OF HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INDIANA STATE DEPARTMENT OF HEALTH",
        "enumeration_date": "2010-03-08",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "LIXIA",
        "authorized_official_title_or_position": "LABORATORY DIRECTOR",
        "authorized_official_telephone_number": "317-921-8509",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., D(ABMM)"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "15D0662599",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "(LPI):100284680A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Indiana Department of Health State Laboratory",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Indiana State Health Laboratory",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Indiana State Health Laboratory",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.