Mid America Clinical Laboratories, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

15D0995210 Issued in IN

Legal business name

MID AMERICA CLINICAL LABORATORIES, LLC

Practice address

1345 Unity PL
Suite 125
Lafayette, IN 47905-5760

Phone

(765) 449-1848

Fax

(765) 449-8127

NPI assigned

Mar 20, 2006

Last updated

Dec 11, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Thomas Kmetz

Title

Cfo

Phone

(317) 803-1010

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544486400000",
    "number": "1669431649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 N SHADELAND AVE",
            "address_2": "P.O. BOX 19163",
            "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": "1345 UNITY PL",
            "address_2": "SUITE 125",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055760",
            "telephone_number": "765-449-1848",
            "fax_number": "765-449-8127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID AMERICA CLINICAL LABORATORIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-20",
        "last_updated": "2018-12-11",
        "status": "A",
        "authorized_official_last_name": "KMETZ",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "317-803-1010"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IN",
            "license": "15D0995210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200188040B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAP",
            "identifier": "7177548",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "15D0995210",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan L Meyer, OD
• Thomas Lowell Meyer, MD
• William Matthew Meyer, M.D.
• Emma R Michal, CST
• Elizabeth Grace Michels, M.D.
• Mid America Clinical Laboratories, LLC
• Mid-Land Meals, Inc.
• Midwest Brace & Limb Inc
• Midwest Brace and Limb Inc
• Midwest Medical Hearing Centers, Inc.

• Clinical Medical Laboratory in Lafayette, IN
• Providers in Lafayette, 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 Dec 11, 2018; 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.