Mid America Clinical Laboratories, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

15D0999249 Issued in IN

Legal business name

MID AMERICA CLINICAL LABORATORIES, LLC

Practice address

1475 E State Road 44
Connersville, IN 47331-8292

Phone

(765) 825-4460

Fax

(765) 827-8490

NPI assigned

Mar 20, 2006

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

C.E.O./General Manager

Phone

(317) 803-0300

Specialties & licenses 1

Addresses

Other identifiers 3

Member of 4

Organizations this organization is a member of, according to the National Provider Directory.

• Ameripath Indianapolis PC

  • Clinical Medical Laboratory
  • Indianapolis, IN
  • NPI 1316919079

  Member Of

  NPD member
• Community Hospitals of Indiana, Inc

  • Family Medicine Physician
  • Greenwood, IN
  • NPI 1396798625

  Member Of

  NPD member
• St. Vincent Hospital & Health Care Center, Inc.

  • Psychiatric Hospital Unit
  • Indianapolis, IN
  • NPI 1003866740

  Member Of

  NPD member
• Quest Diagnostics Clinical Laboratories Inc

  • Clinical Medical Laboratory
  • Montgomery, AL
  • NPI 1861012361

  Member Of

  NPD member

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221523200000",
    "number": "1689633539",
    "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": "1475 E STATE ROAD 44",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473318292",
            "telephone_number": "765-825-4460",
            "fax_number": "765-827-8490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID AMERICA CLINICAL LABORATORIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-20",
        "last_updated": "2008-09-16",
        "status": "A",
        "authorized_official_last_name": "VANNESS",
        "authorized_official_first_name": "DIANNE",
        "authorized_official_middle_name": "Z.",
        "authorized_official_title_or_position": "C.E.O./GENERAL MANAGER",
        "authorized_official_telephone_number": "317-803-0300",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IN",
            "license": "15D0999249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "15D0999249",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAP",
            "identifier": "7178952",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200188040C",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Betty Sue McDivitt, L.C.S.W.
• Steven Dwight McMahan, M.D.
• Medical Hospitalists LLC
• Meridian Health Services Corp
• Amy Meyer, PSY.D.
• Midwest Chiropractic & Rehab
• Midwest Medical Testing LLC
• Miracle Family Chiropractic
• Jennifer Renee Miracle, D.C.
• David B Moore, DDS

• Clinical Medical Laboratory in Connersville, IN
• Providers in Connersville, 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 Sep 16, 2008; 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.