NPIMap

Organization Active NPI

Compunet Clinical Laboratories, LLC

  • Clinical Medical Laboratory
  • Dayton, OH
National Provider Identifier
1811172216
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
COMPUNET CLINICAL LABORATORIES, LLC
Practice address
999 Brubaker Dr Ste 1
Dayton, OH 45429-3556
Phone
(937) 293-4424
Fax
(937) 297-8229
NPI assigned
Jan 3, 2008
Last updated
Mar 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Authorized official

Name
John M Manier
Title
Cfo
Phone
(937) 297-8202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

999 Brubaker Dr Ste 1
Dayton, OH 45429-3556

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
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

NPI Registry JSON

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1811172216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308 SANDRIDGE DR",
            "city": "MORAINE",
            "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": "999 BRUBAKER DR STE 1",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454293556",
            "telephone_number": "937-293-4424",
            "fax_number": "937-297-8229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPUNET CLINICAL LABORATORIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "MANIER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "937-297-8202"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "690002971",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.