Phoenix Clinical Labs Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

25D1084090 Issued in MS

Legal business name

PHOENIX CLINICAL LABS INC

Practice address

1208 E Pass Rd
Gulfport, MS 39507-3403

Phone

(228) 313-4017

NPI assigned

May 20, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Viatcheslav Sapozhnikov

Title

President

Phone

(228) 313-4017

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1003073891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 E PASS RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395073403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 E PASS RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395073403",
            "telephone_number": "228-313-4017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX CLINICAL LABS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "SAPOZHNIKOV",
        "authorized_official_first_name": "VIATCHESLAV",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "228-313-4017"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MS",
            "license": "25D1084090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PFD LLC
• Hanh Pham, NP
• Addison Phan, PHARM.D.
• Margaret E Phillips, MD
• Sarah Elizabeth Phillips, MS, MD
• Phoenix Independent Living
• Phoenix Independent Living Inc
• Phoenix Independent Living Inc
• Phyllis L Dickerson LCSW
• Physical Therapy Clinic of Gulfport

• Clinical Medical Laboratory in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Clinical Medical Laboratory in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.