M&T Diagnostic Lab Services

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

M&T DIAGNOSTIC LAB SERVICES

Practice address

1411 W 4TH St
Coffeyville, KS 67337-3300

Phone

(620) 251-3666

NPI assigned

Nov 3, 2005

Last updated

Jan 22, 2008By 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

Mrs. Melissa K Wilson, ASCP

Title

Owner

Phone

(620) 515-0619

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200960000000",
    "number": "1417948969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 W 4TH ST",
            "address_2": "PO BOX 312",
            "city": "COFFEYVILLE",
            "state": "KS",
            "postal_code": "673373300",
            "telephone_number": "620-251-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 W 4TH ST",
            "city": "COFFEYVILLE",
            "state": "KS",
            "postal_code": "673373300",
            "telephone_number": "620-251-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M&T DIAGNOSTIC LAB SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2008-01-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "620-515-0619",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ASCP"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00268596",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason B Leeds, PHARM.D.
• Christopher Collin Limes, RT(T)(R)
• Perry Y Lin, MD
• Feyisetan Lott, D.O.
• Brittany Rochelle Love, M.D.
• Erin Macaronas
• Sharon R Marquez, P.T.
• Barbara A McCartney, APRN
• Chad Young McCready, PA-C
• Alissa M McFadden, RD

• Clinical Medical Laboratory in Coffeyville, KS
• Providers in Coffeyville, KS by specialty
• Clinical Medical Laboratory in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; 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.