Mid America Clinical Laboratories, LLC

Organization Active NPI Clinical Medical Laboratory · Williamsport, IN

NPI 1477966778 · NPPES record last updated Jun 4, 2014

Key facts

NPI
1477966778
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Medical Laboratory 291U00000X
License
15D0035759 (IN)
Legal business name
MID AMERICA CLINICAL LABORATORIES, LLC
Practice address
412 N Monroe St
Williamsport, IN 47993-1049
Phone
(765) 762-4072
Fax
(765) 762-4197
NPI assigned
Jun 4, 2014
Organization subpart
No

Authorized official

Name
Mrs. Dianne Z. Vanness
Title
C.E.O./General Manager
Phone
(317) 803-1010

Corporate family (same tax ID) 9

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

National Provider Directory

Tax ID family
Mid America Clinical Laboratories LLC (10 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 15D0035759 IN Yes

Addresses

Primary practice location

412 N Monroe St
Williamsport, IN 47993-1049

Mailing address

2560 N Shadeland Ave
Indianapolis, IN 46219-1705
Phone (317) 803-1010

Other providers in Williamsport, IN

All providers in Williamsport, IN · Clinical Medical Laboratory in Indiana

Sources for this page

Verify at the official NPI Registry.