NPIMap

Organization Active NPI

Compunet Clinical Laboratories LLC

  • Clinical Medical Laboratory
  • Troy, OH
National Provider Identifier
1629073168
Registry record updated Oct 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
36D0348736 Issued in OH
Legal business name
COMPUNET CLINICAL LABORATORIES LLC
Practice address
1888 W Main St
Troy, OH 45373-2304
Phone
(937) 296-0844
Fax
(937) 297-8232
NPI assigned
Jun 20, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2009

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

Authorized official

Name
Mr. John M Manier
Title
Cfo/VP Finance
Phone
(937) 297-8202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 36D0348736 OH Primary

Addresses

Primary practice location

1888 W Main St
Troy, OH 45373-2304

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
690002971OtherRAILROAD MEDICARE PROVIDER NUMBER
690002971OtherOHRAILROAD MEDICARE
2476860MedicaidOH

Other names 1

  • CompuNet Clinical Laboratories 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

National Provider Directory

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": "1255046400000",
    "number": "1629073168",
    "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": "1888 W MAIN ST",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453732304",
            "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": "2009-10-09",
        "status": "A",
        "authorized_official_last_name": "MANIER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO/VP FINANCE",
        "authorized_official_telephone_number": "937-297-8202",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OH",
            "license": "36D0348736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROVIDER NUMBER",
            "identifier": "690002971",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "690002971",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2476860",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CompuNet Clinical Laboratories LTD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Troy, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.