Radid Results Dna Laboratories LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

RADID RESULTS DNA LABORATORIES LLC

Practice address

739 High St Ste 102
Portsmouth, VA 23704-3425

Phone

(757) 800-7301

NPI assigned

Dec 21, 2024

Organization subpart

No

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

Authorized official

Name

Miss Jimeka Levelle Fitzgerald

Title

Ceo

Phone

(757) 800-7301

Specialties & licenses 1

Addresses

Other names 1

• Well Watered Place LLC Other name

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

{
    "created_epoch": "1734739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734739200000",
    "number": "1003624008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 HIGH ST STE 102",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237043425",
            "telephone_number": "757-800-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 HIGH ST STE 102",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237043425",
            "telephone_number": "757-800-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADID RESULTS DNA LABORATORIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-21",
        "last_updated": "2024-12-21",
        "certification_date": "2024-12-21",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "JIMEKA",
        "authorized_official_middle_name": "LEVELLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "757-800-7301",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Well Watered Place LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Vangel Orencia Quilon, NP
• Ben Patrick Quinit
• R.I.S.E. Counseling & Consulting Services, LLC
• David Francis Racicot, M.D.
• Jacob John Radabaugh, MD
• Scott Lee Radke
• Samuel Donald Raffaelli, DDS
• Syed Habeebur Rahman, MD
• Andrea Teresa Rahn, M.D.
• Cheyenne Rahn, DO

• Clinical Medical Laboratory in Portsmouth, VA
• Providers in Portsmouth, VA by specialty
• Clinical Medical Laboratory in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2024; 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.