Az Lab, LLC

Primary specialty

Allergy PhysicianTaxonomy code 207KA0200X

License

4476 Issued in AZ

Legal business name

AZ LAB, LLC

Practice address

2210 S Mill Ave
8
Tempe, AZ 85282-2153

Phone

(623) 242-0346

NPI assigned

Feb 17, 2016

Organization subpart

No

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

Authorized official

Name

Jonna Elaine Demore

Title

Owner

Phone

(623) 242-0346

Specialties & licenses 3

Addresses

Other names 1

• Corebella Allergy & Diagnostics Doing business as

Locations

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

{
    "created_epoch": "1455667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455667200000",
    "number": "1013376151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 S MILL AVE",
            "address_2": "8",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852822153",
            "telephone_number": "623-242-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 S MILL AVE",
            "address_2": "8",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852822153",
            "telephone_number": "623-242-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZ LAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-17",
        "last_updated": "2016-02-17",
        "status": "A",
        "authorized_official_last_name": "DEMORE",
        "authorized_official_first_name": "JONNA",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-242-0346"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": "AZ",
            "license": "4476",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "4476",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "AZ",
            "license": "4476",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corebella Allergy & Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Az Kidney Dr LLC
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• Az Plus LLC
• Az Psychiatry and Counseling, Inc
• Az Secure Trans LLC
• Az Secure Trans LLC

• Allergy Physician in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Allergy Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; 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.