Organization Active NPI

Medical Laboratory Service Inc

  • Clinical Medical Laboratory
  • Jackson, MI
National Provider Identifier
1306350194
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
MEDICAL LABORATORY SERVICE INC
Practice address
2324 Brooklyn Rd
Jackson, MI 49203-4750
Phone
(517) 997-1000
NPI assigned
Dec 1, 2017
Last updated
May 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Authorized official

Name
Mary Iocca-Smith
Title
Member
Phone
(517) 206-7267

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

2324 Brooklyn Rd
Jackson, MI 49203-4750

Mailing address

31700 W 13 Mile Rd # 218
Farmington Hills, MI 48334-2166
Phone (248) 907-3985

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180206000623 MI Part B Supplier - Independent Clinical Laboratory 3779843057 Practice locations: Jackson, MI

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
23D2141799Medical Laboratory Service, Inc2324 Brooklyn Road, Jackson, MI 49203AccreditationFeb 26, 2027

National Provider Directory

National Provider Directory

Locations

31700 W 13 Mile Rd
Ofc 218
Farmington Hills, MI 48334
Phone (248) 462-7112

2324 Brooklyn Rd
Jackson, MI 49203
Phone (248) 462-7112

NPI Registry JSON

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

{
    "created_epoch": "1512086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747958400000",
    "number": "1306350194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31700 W 13 MILE RD # 218",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342166",
            "telephone_number": "248-907-3985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2324 BROOKLYN RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492034750",
            "telephone_number": "517-997-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL LABORATORY SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-01",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A",
        "authorized_official_last_name": "IOCCA-SMITH",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "517-206-7267"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.