{"npi":"1699706770","type":"NPI-2","status":"active","name":{"display":"Medical Diagnostic Laboratory, INC","other":[],"organization_name":"MEDICAL DIAGNOSTIC LABORATORY, INC","authorised_official":"Paul Pongpitoon"},"specialty":{"primary_taxonomy":"291U00000X","primary_taxonomy_description":"Clinical Medical Laboratory","slug":"clinical-medical-laboratory","schema_org_specialty":"Pathology","all":[{"code":"291U00000X","description":"Clinical Medical Laboratory","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"45 SHEFFIELD DR","city":"BELLEVILLE","state":"IL","postal_code":"622233557","country_code":"US","phone":"6182330522"},{"purpose":"MAILING","street_1":"45 SHEFFIELD DR","city":"BELLEVILLE","state":"IL","postal_code":"622233557","country_code":"US","phone":"6182330522"}],"license":null,"identifiers":[{"type_code":"01","label":"Other","value":"32714","state":"IL","issuer":"GHP"},{"type_code":"01","label":"Other","value":"3509010","state":"IL","issuer":"UHC"},{"type_code":"01","label":"Other","value":"110795","state":"IL","issuer":"HEALTHLINK"},{"type_code":"01","label":"Other","value":"31251","state":"MO","issuer":"BCBS OF MISSOURI"},{"type_code":"01","label":"Other","value":"50000463","state":"IL","issuer":"BCBS OF ILLINOIS"}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2006-07-06","last_updated":"2020-08-22","_meta":{"source":"NPPES","snapshot_date":"2020-08-22","doc_url":"https://findmynpi.com/api"}}