Fort Wayne Medical Laboratory Corporation

LBN: Fort Wayne Medical Laboratory Corporation
Fort Wayne Medical Laboratory Corporation is an health care organization with primary practice located at 2470 Lake Ave , Ft Wayne IN 46805-5406. The organization recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Medical Laboratory, which is considered as the primary health care specialty. Fort Wayne Medical Laboratory Corporation can be contacted via phone (260) 424-2195, or through Kim, Seung S via phone (260) 373-3657.

Contact Information

Primary practice address
2470 Lake Ave Ft Wayne IN 46805-5406
Phone: (260) 424-2195
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Kim, Seung S MD., PHD
Phone: (260) 373-3657

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Medical Laboratory 246RM2200X 50000070A Indiana

Profile Details

NPI number 1285610733
LBN Legal business name Fort Wayne Medical Laboratory Corporation
DBA Doing business as
Authorized official Kim, Seung S MD., PHD
Entity Organization
Organization subpart 1 No
Enumeration date Dec 16th, 2005
Last updated Mar 1st, 2012 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1285610733 NPPES
Indiana MEDICAID 200402190A

Popular Providers