MEDICARE: CINCINNATI MED LAB

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000013336	OTHER	OH	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	3500311	OTHER	OH	UHC

General Provider Information

NPI Number	:	1447362843
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CINCINNATI MED LAB

Provider Business Mailing Address
First Line	:	5437 DENGAIL DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-4704
Country	:	US
Telephone Number	:	513-702-2316
Fax Number	:

Provider Business Practice Location Address
First Line	:	5437 DENGAIL DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-4704
Country	:	US
Telephone Number	:	513-702-2316
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CAROL FRANZOSA
Credential	:
Telephone Number	:	513-702-2316

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	08/22/2020

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Directions to “CINCINNATI MED LAB ” Practice Location

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