Healthcare Provider Details

I. General information

NPI: 1790995587
Provider Name (Legal Business Name): COMPUNET CLINICAL LABORATORIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3120 GOVERNORS PLACE BLVD
KETTERING OH
45409-1328
US

IV. Provider business mailing address

2308 SANDRIDGE DR
DAYTON OH
45439-1847
US

V. Phone/Fax

Practice location:
  • Phone: 937-528-0315
  • Fax: 937-297-8229
Mailing address:
  • Phone: 937-296-0844
  • Fax: 937-297-8229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: CINDY SMOTHERMAN
Title or Position: REVENUE CYCLE DIRECTOR
Credential:
Phone: 513-307-0748