Organization
FORT WAYNE MEDICAL LABORATORY CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEUNG S KIM MD., PHD (LABORATORY DIRECTOR)
(260) 373-3657
Entity
Organization
Contact information
Practice address
2470 LAKE AVE, FT WAYNE, IN 46805-5406
(260) 424-2195
Mailing address
2470 LAKE AVE, FORT WAYNE, IN 46805-5406
(260) 424-2195
Taxonomy
Speciality
Code
Description
License number
State
246RM2200X
Medical Laboratory Technician
Primary
50000070A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200402190A
—
IN
Enumeration date
12/16/2005
Last updated
03/01/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us