Organization Active NPI

Medisure Labs Inc.

  • Clinical Medical Laboratory
  • Harrisburg, PA
National Provider Identifier
1790643617
Registry record updated Jan 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
MEDISURE LABS INC.
Practice address
4815 Jonestown Rd Ste 201
Harrisburg, PA 17109-1750
Phone
(203) 722-5981
NPI assigned
Jan 10, 2026
Last updated
Jan 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2026

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

Authorized official

Name
Mrs. Chandana Kancharakuntla Samson
Title
President
Phone
(203) 722-5981

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

4815 Jonestown Rd Ste 201
Harrisburg, PA 17109-1750

Mailing address

4815 Jonestown Rd Ste 201
Harrisburg, PA 17109-1750
Phone (203) 722-5981

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260514001717 PA Part B Supplier - Independent Clinical Laboratory 1557830007 Practice locations: Harrisburg, PA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2340686Medisure Labs Inc4815 Jonestown Rd, Ste 201, Harrisburg, PA 17109RegistrationMar 19, 2028

National Provider Directory

National Provider Directory

Locations

4815 Jonestown Rd
Ste 201
Harrisburg, PA 17109
Phone (203) 722-5981

NPI Registry JSON

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

{
    "created_epoch": "1768003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768003200000",
    "number": "1790643617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 JONESTOWN RD STE 201",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171091750",
            "telephone_number": "203-722-5981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 JONESTOWN RD STE 201",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171091750",
            "telephone_number": "203-722-5981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDISURE LABS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-10",
        "last_updated": "2026-01-10",
        "certification_date": "2026-01-10",
        "status": "A",
        "authorized_official_last_name": "KANCHARAKUNTLA SAMSON",
        "authorized_official_first_name": "CHANDANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-722-5981",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.