United States Medical Laboratory

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

UNITED STATES MEDICAL LABORATORY

Practice address

3684 Highway 150 Ste 2
Floyds Knobs, IN 47119-9692

Phone

(812) 728-8202

NPI assigned

Jun 5, 2018

Organization subpart

No

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

Authorized official

Name

Branislava Matevich

Title

Chief Executive Officer

Phone

(812) 728-8202

Specialties & licenses 1

Addresses

Other names 1

• US MED LAB Doing business as

Locations

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

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539820800000",
    "number": "1720570708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3684 HIGHWAY 150 STE 2",
            "city": "FLOYDS KNOBS",
            "state": "IN",
            "postal_code": "471199692",
            "telephone_number": "812-728-8202",
            "fax_number": "812-670-5334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3684 HIGHWAY 150 STE 2",
            "city": "FLOYDS KNOBS",
            "state": "IN",
            "postal_code": "471199692",
            "telephone_number": "812-728-8202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3660 Paoli Pike Ste 2",
            "address_purpose": "LOCATION",
            "city": "Floyds Knobs",
            "state": "IN",
            "postal_code": "471199735",
            "country_code": "US",
            "telephone_number": "812-728-8202 x104",
            "fax_number": "812-670-5334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "UNITED STATES MEDICAL LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-05",
        "last_updated": "2018-10-18",
        "status": "A",
        "authorized_official_last_name": "MATEVICH",
        "authorized_official_first_name": "BRANISLAVA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "812-728-8202"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "US MED LAB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• David James Vaughn III, D.C., CSCS
• James Robert Vaughn III, LMT

• All providers in Floyds Knobs, IN
• Clinical Medical Laboratory in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.