Mid America Clinical Laboratories, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

15D0686555 Issued in IN

Legal business name

MID AMERICA CLINICAL LABORATORIES, LLC

Practice address

301 Henry St
North Vernon, IN 47265-1030

Phone

(812) 352-4270

Fax

(812) 352-4202

NPI assigned

Feb 28, 2014

Organization subpart

No

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

Authorized official

Name

Ms. Dianne Z. Vanness

Title

Ceo/General Manager

Phone

(317) 803-1010

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1393545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393545600000",
    "number": "1659796555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462191705",
            "telephone_number": "317-803-1010",
            "fax_number": "317-803-0186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HENRY ST",
            "city": "NORTH VERNON",
            "state": "IN",
            "postal_code": "472651030",
            "telephone_number": "812-352-4270",
            "fax_number": "812-352-4202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID AMERICA CLINICAL LABORATORIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-28",
        "last_updated": "2014-02-28",
        "status": "A",
        "authorized_official_last_name": "VANNESS",
        "authorized_official_first_name": "DIANNE",
        "authorized_official_middle_name": "Z.",
        "authorized_official_title_or_position": "CEO/GENERAL MANAGER",
        "authorized_official_telephone_number": "317-803-1010",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IN",
            "license": "15D0686555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAP",
            "identifier": "7524362",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "15D0686555",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Max a Henry MD
• Kara May, PTA
• Ashly Nichole McDonald
• Joseph McMahan, LMHC, MA, NCC
• Melissa R Hunter LMHC LLC
• Miller Chiropractic Clinic PC
• Kerigan Miller
• Leonard Ezekiel Miller, PSY.D., HSPP
• Marc Miller, RPH
• Trevor Charles Miller, D.C.

• Clinical Medical Laboratory in North Vernon, IN
• Providers in North Vernon, IN by specialty
• Clinical Medical Laboratory in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; 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.