Main Line Clinical Laboratories

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

000242 Issued in PA

Legal business name

MAIN LINE CLINICAL LABORATORIES

Practice address

100 E Lancaster Ave
Wynnewood, PA 19096-3450

Phone

(610) 229-4100

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Michael J Buongiorno

Title

Chief Financial Officer

Phone

(610) 526-8480

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Main Line Clinical Labs - Lankenau Other name

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

Main Line Clinical Laboratories4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Main Line Clinical Laboratories

  • Clinical Medical Laboratory
  • Paoli, PA
  • NPI 1578689865
  NPD tax ID
• Main Line Clinical Laboratories

  • Clinical Medical Laboratory
  • Bryn Mawr, PA
  • NPI 1750407045
  NPD tax ID
• Main Line Health Laboratories

  • Clinical Medical Laboratory
  • Newtown Square, PA
  • NPI 1750562401
  NPD tax ID

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669598959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 E HAVERFORD RD",
            "address_2": "SUITE 110",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103850",
            "telephone_number": "610-526-8480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "610-229-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN LINE CLINICAL LABORATORIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUONGIORNO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "610-526-8480",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PA",
            "license": "000242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015758270006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Main Line Clinical Labs - Lankenau",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Emma Katherine Madigan, DO
• Madlyn and Leonard Abramson Center for Jewish Life (Abramson Senior Care at Lankenau Medical Center)
• Diksha Mahendru, M.D.
• Elizabeth Mahoney, CRNA
• Heather Denean Mahoney, M.D.
• Main Line Dental Health Associates
• Main Line Hand Surgery, PC
• Main Line Health Imaging LP
• Main Line Health Imaging LP
• Main Line Healthcare (Main Line Health Urgent Care and Extended Outpatient Care)

• Clinical Medical Laboratory in Wynnewood, PA
• Providers in Wynnewood, PA by specialty
• Clinical Medical Laboratory in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.