Organization Active NPI

Mill Creek Medical Laboratory LLC

  • Clinical Medical Laboratory
  • Salem, OR
National Provider Identifier
1275974016
Registry record updated Jul 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
MILL CREEK MEDICAL LABORATORY LLC
Practice address
3300 State St
Salem, OR 97301-5063
Phone
(503) 561-5350
NPI assigned
Jul 9, 2013
Last updated
Jul 9, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2013

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

Authorized official

Name
Mark Magilner, MDNPI 1891856480
Title
Authorized Official
Phone
(503) 561-5350

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 Primary

Addresses

Primary practice location

3300 State St
Salem, OR 97301-5063

Mailing address

5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone (800) 288-8325

National Provider Directory

National Provider Directory

Locations

3300 State St
Salem, OR 97301
Phone (503) 561-2864

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": "1373328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373328000000",
    "number": "1275974016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509",
            "telephone_number": "800-288-8325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 STATE ST",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973015063",
            "telephone_number": "503-561-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILL CREEK MEDICAL LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-09",
        "last_updated": "2013-07-09",
        "status": "A",
        "authorized_official_last_name": "MAGILNER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "503-561-5350",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2013; 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.