MEDICARE: ZEERAK MTI LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1730021239
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZEERAK MTI LLC

Provider Business Mailing Address
First Line	:	2775 ORCHARD RUN RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45449-2831
Country	:	US
Telephone Number	:	913-204-0167
Fax Number	:

Provider Business Practice Location Address
First Line	:	2775 ORCHARD RUN RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45449-2831
Country	:	US
Telephone Number	:	913-204-0167
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. WILLARD SOWDER
Credential	:
Telephone Number	:	913-204-0167

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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