Provider Demographics
NPI:1043928484
Name:COMPUNET CLINICAL LABORATORIES LLC
Entity Type:Organization
Organization Name:COMPUNET CLINICAL LABORATORIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMOTHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-307-0748
Mailing Address - Street 1:2308 SANDRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1856
Mailing Address - Country:US
Mailing Address - Phone:937-297-8228
Mailing Address - Fax:
Practice Address - Street 1:9000 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45415-1180
Practice Address - Country:US
Practice Address - Phone:678-493-7734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPUNET CLINICAL LABORATORIES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory