NPIMap

Organization Active NPI

Compunet Clinical Laboratories LLC

  • Clinical Medical Laboratory
  • Moraine, OH
National Provider Identifier
1619972254
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
36D0350049 Issued in OH
Legal business name
COMPUNET CLINICAL LABORATORIES LLC
Practice address
2308 Sandridge Dr
Moraine, OH 45439-1847
Phone
(937) 296-0844
Fax
(937) 297-8232
NPI assigned
Jun 20, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Authorized official

Name
Teresa M Williams
Title
President
Phone
(937) 297-8228

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 36D0350049 OH Primary

Addresses

Primary practice location

2308 Sandridge Dr
Moraine, OH 45439-1847

Mailing address

2308 Sandridge Dr
Moraine, OH 45439-1847
Phone (937) 296-0844

Other identifiers 4

IdentifierTypeStateIssuer
0654619OtherOHAETNA
000000013050OtherOHANTHEM BC/BS
0658515MedicaidOH
690002971OtherOHRAILROAD MEDICARE

Other names 1

  • CompuNet Clinical Labortories LTD Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050901000018 OH Part B Supplier - Independent Clinical Laboratory 4385676188 18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Centerville, OH; Troy, OH; Moraine, OH; Middletown, OH; Miamisburg, OH; Jamestown, OH; Kettering, OH; Dayton, OH…

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

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
36D0350049Compunet Clinical Labs2308 Sandridge Drive, Moraine, OH 45439AccreditationFeb 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Compunet Sunset12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767916800000",
    "number": "1619972254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308 SANDRIDGE DR",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391847",
            "telephone_number": "937-296-0844",
            "fax_number": "937-297-8232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2308 SANDRIDGE DR",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391847",
            "telephone_number": "937-296-0844",
            "fax_number": "937-297-8232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPUNET CLINICAL LABORATORIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-20",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-297-8228"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OH",
            "license": "36D0350049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0654619",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000013050",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0658515",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "690002971",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CompuNet Clinical Labortories LTD",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "CompuNet Clinical Labortories LTD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Moraine, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; 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.