NPIMap

Organization Active NPI

Integrated Diagnostic Laboratory, LLC

Doing business as Integrated Diagnostic Lab

  • Clinical Medical Laboratory
  • Evansville, IN
National Provider Identifier
1699743369
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
INTEGRATED DIAGNOSTIC LABORATORY, LLC
Doing business as
Integrated Diagnostic Lab
Practice address
600 Mary Street
Evansville, IN 47747-0001
Phone
(812) 450-5000
NPI assigned
Mar 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Henry BockelmanNPI 1164417507
Title
President
Phone
(812) 450-5000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

600 Mary Street
Evansville, IN 47747-0001

Mailing address

PO Box 3024
Evansville, IN 47730-3024
Phone (800) 467-2392

Other names 1

  • Integrated Diagnostic Lab Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699743369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3024",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477303024",
            "telephone_number": "800-467-2392",
            "fax_number": "812-471-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MARY STREET",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477470001",
            "telephone_number": "812-450-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED DIAGNOSTIC LABORATORY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOCKELMAN",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-450-5000",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integrated Diagnostic Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.