| Jackson Laboratory LLC | |
|
290 Dietz Dr Greenwood IN 46143-5652 | |
| (223) 205-0229 | |
| (223) 205-0229 |
| Full Name | Jackson Laboratory LLC |
|---|---|
| Speciality | Clinic/center |
| Location | 290 Dietz Dr, Greenwood, Indiana |
| Authorized Official Name and Position | Bhupinder Singh (OWNER) |
| Authorized Official Contact | 2232050229 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Laboratory LLC 290 Dietz Dr Greenwood IN 46143-5652 Ph: (223) 205-0229 | Jackson Laboratory LLC 290 Dietz Dr Greenwood IN 46143-5652 Ph: (223) 205-0229 |
| NPI Number | 1154239960 |
|---|---|
| Provider Enumeration Date | 09/01/2026 |
| Last Update Date | 09/22/2026 |
| Certification Date | 09/22/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154239960 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| 261QH0100X | Clinic/center - Health Service | () | Secondary |
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