NPIMap

Organization Active NPI

Compunet Clinical Laboratories, LLC

  • Clinical Medical Laboratory
  • Kettering, OH
National Provider Identifier
1790995587
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
COMPUNET CLINICAL LABORATORIES, LLC
Practice address
3120 Governors Place Blvd
Kettering, OH 45409-1328
Phone
(937) 528-0315
Fax
(937) 297-8229
NPI assigned
May 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Authorized official

Name
Cindy Smotherman
Title
Revenue Cycle Director
Phone
(513) 307-0748

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

3120 Governors Place Blvd
Kettering, OH 45409-1328

Mailing address

2308 Sandridge Dr
Dayton, OH 45439-1847
Phone (937) 296-0844

Other identifiers 2

IdentifierTypeStateIssuer
2796701MedicaidOH
690002971OtherOHRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050901000018 OH Part B Supplier - Independent Clinical Laboratory 4385676188 18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Centerville, OH; Troy, OH; Moraine, OH; Middletown, OH; Miamisburg, OH; Jamestown, OH; Kettering, OH; Dayton, OH…

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Compunet Sunset12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Member of 2

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

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767916800000",
    "number": "1790995587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308 SANDRIDGE DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454391847",
            "telephone_number": "937-296-0844",
            "fax_number": "937-297-8229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 GOVERNORS PLACE BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454091328",
            "telephone_number": "937-528-0315",
            "fax_number": "937-297-8229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPUNET CLINICAL LABORATORIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A",
        "authorized_official_last_name": "SMOTHERMAN",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "REVENUE CYCLE DIRECTOR",
        "authorized_official_telephone_number": "513-307-0748"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2796701",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "690002971",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.