Dermatopathology Laboratory of Central States - Michigan

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

DERMATOPATHOLOGY LABORATORY OF CENTRAL STATES - MICHIGAN

Practice address

1100 Owendale Dr
Suite a
Troy, MI 48083-1914

Phone

(800) 592-5192

Fax

(248) 519-1047

NPI assigned

Mar 14, 2015

Organization subpart

Yes

Parent organization

DERMATOPATHOLOGY LABORATORY OF CENTRAL STATESAs reported in NPPES

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

Authorized official

Name

John J. Macke

Title

Chief Executive Officer

Phone

(937) 312-3826

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Dermatopathology of Cen2 organizations share this tax ID, including this one

Part of

Dermatopathology of Cen

Other organizations with this tax ID 1

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

• Dermatopathology Laboratory of Central States

  • Clinical Medical Laboratory
  • Dayton, OH
  • NPI 1912914144
  NPD tax ID

Locations

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

{
    "created_epoch": "1426291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426291200000",
    "number": "1538552500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7835 PARAGON RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454594021",
            "telephone_number": "800-532-3232",
            "fax_number": "800-840-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 OWENDALE DR",
            "address_2": "SUITE A",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831914",
            "telephone_number": "800-592-5192",
            "fax_number": "248-519-1047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOPATHOLOGY LABORATORY OF CENTRAL STATES - MICHIGAN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DERMATOPATHOLOGY LABORATORY OF CENTRAL STATES",
        "enumeration_date": "2015-03-14",
        "last_updated": "2015-03-14",
        "status": "A",
        "authorized_official_last_name": "MACKE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "937-312-3826"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dentists R US
• Dentists R US
• Bhuvneesh Singh Deol, RPH
• Nicholas Depietro
• Dequindre Physical Therapy & Rehab Service Inc.
• Paul E Dery
• Shital Desai
• Snehal R Desai, M.D.
• Umang Desai
• Desjardins Therapeutic Services LLC

• Clinical Medical Laboratory in Troy, MI
• Providers in Troy, MI by specialty
• Clinical Medical Laboratory in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.