Mid America Clinical Laboratories, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

15D1029535 Issued in IN

Legal business name

MID AMERICA CLINICAL LABORATORIES, LLC

Practice address

1321 Unity PL
Suite B
Lafayette, IN 47905-5793

Phone

(317) 803-1010

Fax

(317) 803-0186

NPI assigned

Nov 15, 2012

Last updated

Nov 15, 2012By 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

Ms. Dianne Z. Vanness

Title

C.E.O./General Manager

Phone

(317) 803-0300

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1831433051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462191705",
            "telephone_number": "317-803-1010",
            "fax_number": "317-803-0186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 UNITY PL",
            "address_2": "SUITE B",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055793",
            "telephone_number": "317-803-1010",
            "fax_number": "317-803-0186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID AMERICA CLINICAL LABORATORIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "VANNESS",
        "authorized_official_first_name": "DIANNE",
        "authorized_official_middle_name": "Z.",
        "authorized_official_title_or_position": "C.E.O./GENERAL MANAGER",
        "authorized_official_telephone_number": "317-803-0300",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IN",
            "license": "15D1029535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAP",
            "identifier": "719071402",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "15D1029535",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Lowell Meyer, MD
• William Matthew Meyer, M.D.
• Emma R Michal, CST
• Elizabeth Grace Michels, M.D.
• Mid America Clinical Laboratories, LLC
• Mid-Land Meals, Inc.
• Midwest Brace & Limb Inc
• Midwest Brace and Limb Inc
• Midwest Medical Hearing Centers, Inc.
• Scott Carl Miethke, MD

• Clinical Medical Laboratory in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Clinical Medical Laboratory in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.