Healthcare Provider Details

I. General information

NPI: 1447192158
Provider Name (Legal Business Name): LYND CLINICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 CITY MARKET DR
SALTILLO MS
38866-7002
US

IV. Provider business mailing address

817 BROADWAY FL 7
NEW YORK NY
10003-4709
US

V. Phone/Fax

Practice location:
  • Phone: 615-862-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: MATT ULLUM
Title or Position: CEO
Credential:
Phone: 615-862-1000