Main Line Clinical Laboratories

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

000213 Issued in PA

Legal business name

MAIN LINE CLINICAL LABORATORIES

Practice address

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121

Phone

(610) 229-4100

NPI assigned

Mar 21, 2007

Last updated

Aug 22, 2020By 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

Mr. Michael J Buongiorno

Title

Chief Financial Officer

Phone

(610) 526-8480

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Main Line Hospital Bryn Mawr 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
  • Wynnewood, PA
  • NPI 1669598959
  NPD tax ID
• Main Line Health Laboratories

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

Locations

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": "1750407045",
    "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": "130 S BRYN MAWR AVE",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103121",
            "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": "000213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015758270003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Main Line Hospital Bryn Mawr",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• George Magakis Jr., PHD
• Ennio Magnarelli, RPH
• Jana Marie Mahon, PA-C
• Thy Mai, DO
• Main Line Adult Day Center
• Main Line Counseling Partners
• Main Line Family Dentistry
• Main Line Family Practice
• Main Line Fertility & Reproductive Med LTD
• Main Line Fertility Center

• Clinical Medical Laboratory in Bryn Mawr, PA
• Providers in Bryn Mawr, 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.